Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4901002776 | MI |
NPI | 1003980483 |
---|---|
Provider Name | Dr. David Blair Whitney |
First Address | East Lansing, MI 48823-9656 |
Second Address | Lansing, MI 48911-5807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |