Provider Demographics
NPI:1730162140
Name:WHITING, ALBERT SIDNEY JR (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:SIDNEY
Last Name:WHITING
Suffix:JR
Gender:M
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 576
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-0576
Mailing Address - Country:US
Mailing Address - Phone:207-496-6851
Mailing Address - Fax:207-492-5791
Practice Address - Street 1:647 MAIN ST
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-4464
Practice Address - Country:US
Practice Address - Phone:207-496-6851
Practice Address - Fax:207-492-5791
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100197207W00000X
MEMD17756207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912880Medicaid
NY180042535OtherPALMETTO GBA
NC12880OtherBCBS OF NC
NC0800138OtherUNITED HEALTHCARE
NC8912880Medicaid
NY180042535OtherPALMETTO GBA