Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 24491 | NE |
NPI | 1265639801 |
---|---|
Provider Name | Dr. Susan Lynn Whiteway |
First Address | Jbsa Ft Sam Houston, TX 78234-4504 |
Second Address | Bethesda, MD 20889-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 17/07/2020 |