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Individual

CHARLES D WHITING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1413 JOHN B WHITE SR BLVD STE D, SPARTANBURG, SC 29306-3995
(864) 587-5768
(864) 587-5776
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
803
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0073PA
SC
Enumeration date
12/15/2006
Last updated
02/22/2022
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