Whitaker, Willie Roscoe

Whitaker, Willie Roscoe is an sole proprietor health care provider with primary practice located at 2117 Simonton Rd Suite 102, Statesville NC 28625-8403. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Whitaker, Willie Roscoe can be contacted via phone (704) 872-8422.

Contact Information

Primary practice address
2117 Simonton Rd Suite 102 Statesville NC 28625-8403
Phone: (704) 872-8422
Fax: (704) 872-8705
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X NC2003-00428 North Carolina
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 2003-00428 North Carolina

Profile Details

NPI number 1861489759
LBN Legal business name Whitaker, Willie Roscoe
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2005
Last updated Mar 21st, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861489759 NPPES
North Carolina Other C8620 MEDCOST
North Carolina Other 38354 MEDCOST
North Carolina MEDICAID 89134J6 MEDCOST
North Carolina Other E73961 MEDCOST
North Carolina Other 134J6 MEDCOST
North Carolina Other 3324386 MEDCOST
North Carolina Other P00010140 MEDCOST

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