Provider Demographics
NPI:1841265014
Name:MCCLINCY, WHITNEY PAIGE (MD)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:PAIGE
Last Name:MCCLINCY
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:PO BOX 79777
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0777
Mailing Address - Country:US
Mailing Address - Phone:434-654-7794
Mailing Address - Fax:434-977-9808
Practice Address - Street 1:3263 PROFFIT RD STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-5639
Practice Address - Country:US
Practice Address - Phone:434-654-4600
Practice Address - Fax:434-975-1834
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043613207Q00000X
VA0101232094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1020296Medicaid
8805231Medicare PIN
WA1020296Medicaid