Individual
EDWIN GLENN WHITNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
157 CLINIC AVE, SUITE 302, CARROLLTON, GA 30117-4454
(770) 812-5902
(770) 812-5903
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 838-8710
(770) 838-8563
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
044604
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000841079B
—
GA
05
—
000841079C
—
GA
05
—
000841079D
—
GA
05
—
000841079I
—
GA
Enumeration date
12/27/2006
Last updated
03/14/2016
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