Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 30337 | MN |
NPI | 1003836479 |
---|---|
Provider Name | Dr. David W Whiting |
First Address | St Louis Park, MN 55426-1607 |
Second Address | St Louis Park, MN 55426-1607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 02/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
146393400 | (05) | MN |
D81511 | (02) | MN |