Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 4301101516 | MI |
Y | 207VX0000X | Obstetrician | 35127572 | OH |
NPI | 1356605562 |
---|---|
Provider Name | Dr. Amanda Joyce Whittaker |
First Address | Toledo, OH 43623-3537 |
Second Address | Toledo, OH 43623-3537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2012 |
Last Update Date | 09/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0172547 | (05) | OH |