Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301097836 | MI |
Y | 2080P0204X | Pediatric Emergency Doctor | 4301097836 | MI |
NPI | 1275797565 |
---|---|
Provider Name | Valerie Whitcomb |
First Address | Minneapolis, MN 55404-4518 |
Second Address | Minneapolis, MN 55404-4518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 08/07/2014 |