Individual
DR. AUTUMN BETH WHITLOCK-MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22119
WV
207R00000X
Internal Medicine Physician
39466
IA
208000000X
Pediatrics Physician
39466
IA
208000000X
Pediatrics Physician
Primary
R9558
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005860
—
WV
05
—
PENDING
—
TX
Enumeration date
06/25/2006
Last updated
04/20/2021
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