Whitaker, Bruce Lee
Whitaker, Bruce Lee is an individual health care provider with primary practice located at 1350 Walton Way , Augusta GA 30901-2612. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Whitaker, Bruce Lee can be contacted via phone (706) 774-7745.Contact Information
Primary practice address
1350 Walton Way
Augusta GA 30901-2612
Phone: (706) 774-7745
Fax: (706) 774-5789
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 5101016483 | Michigan |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 062124 | Louisiana |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 5101016483 | Michigan |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | OC-0415 | Idaho |
Profile Details
| NPI number | 1790923969 |
|---|---|
| LBN Legal business name | Whitaker, Bruce Lee |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 27th, 2009 |
| Last updated | Feb 5th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790923969 | NPPES |
| Michigan | Other | 0E00425 | BLUE CROSS BLUE SHIELD |
| Michigan | MEDICAID | 1790923969 | BLUE CROSS BLUE SHIELD |
Popular Providers
-
Quinn, Michael W.
3614 J. Dewey Gray Circle Bldg B., Augusta GA 30909 -
Loebl, Donald
1350 Walton Way 3Rd Fl Critical Care Medicine, Augusta GA 30901-2612 -
Ramage, Anthony S
1120 15Th St , Augusta GA 30912-3821 -
Vaughn, Steven B
1350 Walton Way 3Rd Fl Critical Care Medicine, Augusta GA 30901-2612 -
Friedman, Bruce C
3651 Wheeler Rd Burn Center, Augusta GA 30909-6521 -
Barnes, Jerome D
1350 Walton Way 3Rd Floor, Augusta GA 30901-2612 -
Oribabor, Charles E
1120 15Th St , Augusta GA 30912-3609 -
Epperly, Neil A
1350 Walton Way 3Rd Fl, Critical Care Medicine, Augusta GA 30901-2612