Provider Demographics
NPI:1609688779
Name:WHITTINGTON DERMATOLOGY LLC
Entity type:Organization
Organization Name:WHITTINGTON DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-398-4234
Mailing Address - Street 1:800 MACARTHUR BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2917
Mailing Address - Country:US
Mailing Address - Phone:219-398-4234
Mailing Address - Fax:
Practice Address - Street 1:800 MACARTHUR BLVD STE 6
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2917
Practice Address - Country:US
Practice Address - Phone:219-398-4234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty