Individual
DR. PAUL R. WHITWAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 W COUNTRY CLUB RD, SUITE #102, ROSWELL, NM 88201-5224
(575) 623-3333
(575) 624-4781
Mailing address
601 W COUNTRY CLUB RD, SUITE #102, ROSWELL, NM 88201-5224
(575) 623-3333
(575) 624-4781
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
73-226
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21977364
—
NM
Enumeration date
05/18/2006
Last updated
08/21/2014
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