Provider Demographics
NPI:1699871368
Name:WHITMER, GAYLE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:ANN
Last Name:WHITMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 RITCHIE HWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4303
Mailing Address - Country:US
Mailing Address - Phone:443-837-1521
Mailing Address - Fax:410-544-5449
Practice Address - Street 1:90 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4303
Practice Address - Country:US
Practice Address - Phone:443-837-1521
Practice Address - Fax:410-544-5449
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR25111207Q00000X
ORMD25111207RH0002X
MDD84226207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV13847OtherNEVADA MEDICAL LICENSE
ID807577600Medicaid
ORMD25111OtherOREGON MEDICAL LICENSE
MDD84226OtherMD LICENSE
IDM-9961OtherIDAHO MEDICAL LICENSE
ORR135498Medicare PIN
IDM-9961OtherIDAHO MEDICAL LICENSE
ORR135499Medicare PIN
ORMD25111OtherOREGON MEDICAL LICENSE