Provider Demographics
NPI:1649002288
Name:WHITFIELD, SEAN
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 BROER AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-3012
Mailing Address - Country:US
Mailing Address - Phone:419-340-3902
Mailing Address - Fax:
Practice Address - Street 1:912 BROER AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-3012
Practice Address - Country:US
Practice Address - Phone:419-340-3902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide