Provider Demographics
NPI:1124096805
Name:WHARTON, HOWARD S (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:S
Last Name:WHARTON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:892 E CHICAGO ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2063
Mailing Address - Country:US
Mailing Address - Phone:517-278-2301
Mailing Address - Fax:517-278-2784
Practice Address - Street 1:892 E CHICAGO ST
Practice Address - Street 2:SUITE C
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2063
Practice Address - Country:US
Practice Address - Phone:517-278-2301
Practice Address - Fax:517-278-2784
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MI4031029569208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB47854Medicare UPIN