Provider Demographics
NPI:1316165277
Name:WHITAKER, ANNE WILLIS (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:WILLIS
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:17 WYOMING DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-6005
Mailing Address - Country:US
Mailing Address - Phone:401-521-3400
Mailing Address - Fax:401-521-3456
Practice Address - Street 1:339 ANGELL ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3245
Practice Address - Country:US
Practice Address - Phone:401-521-3400
Practice Address - Fax:401-521-3456
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI82612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry