Provider Demographics
NPI:1538151584
Name:WHITMYER, JAMES H (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:WHITMYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18303 E 10 MILE RD
Mailing Address - Street 2:STE 500
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4992
Mailing Address - Country:US
Mailing Address - Phone:586-498-5160
Mailing Address - Fax:586-498-5199
Practice Address - Street 1:36015 UTICA RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-1021
Practice Address - Country:US
Practice Address - Phone:586-741-4650
Practice Address - Fax:586-741-4655
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301070292207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4204107Medicaid
MIM75620063Medicare ID - Type Unspecified
MI4204107Medicaid