Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | MD043670 | DC |
Y | 208000000X | Pediatrician | MD043670 | DC |
NPI | 1790045102 |
---|---|
Provider Name | Scott Jefferson Whetsell |
First Address | North Charleston, SC 29406-6566 |
Second Address | Washington, DC 20037-2761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2012 |
Last Update Date | 06/04/2020 |