Provider Demographics
NPI:1588974265
Name:WHITAKER, DARIUS ANTONIO SR (MS PA-C)
Entity type:Individual
Prefix:
First Name:DARIUS
Middle Name:ANTONIO
Last Name:WHITAKER
Suffix:SR
Gender:M
Credentials:MS PA-C
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Mailing Address - Street 1:409 S 2ND ST STE 2F
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-988-0000
Mailing Address - Fax:717-782-5716
Practice Address - Street 1:300 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331
Practice Address - Country:US
Practice Address - Phone:717-988-0000
Practice Address - Fax:717-782-5716
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2021-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA057541363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant