Provider Demographics
NPI:1194710608
Name:WHITING, DONALD M (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:M
Last Name:WHITING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 W CHESTNUT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4658
Mailing Address - Country:US
Mailing Address - Phone:724-228-1414
Mailing Address - Fax:724-228-8579
Practice Address - Street 1:380 W CHESTNUT ST STE 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4658
Practice Address - Country:US
Practice Address - Phone:724-228-1414
Practice Address - Fax:724-228-8579
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036859E207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001243694Medicaid
WV0123013000Medicaid
PA001243694Medicaid
667352Medicare PIN
PA66735D1SMedicare PIN
PA667352N79Medicare PIN
WV0123013000Medicaid
PA0012436940001Medicaid