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Organization

MEDICAL HOME DEVELOPMENT GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AUDREY WHETSELL MS (CEO)
(843) 412-5548
Entity
Organization

Contact information

Practice address
2112 F ST NW STE 504, WASHINGTON, DC 20037-2761
(202) 684-2784
(866) 643-9237
Mailing address
4975 LACROSS RD, SUITE 151, N CHARLESTON, SC 29406-6523
(843) 412-5548
(866) 643-9237

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207QA0401X
Addiction Medicine (Family Medicine) Physician
207QA0505X
Adult Medicine Physician
251B00000X
Case Management Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
086030300
DC
Enumeration date
09/19/2013
Last updated
09/08/2022
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