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DR. BRUCE LEE WHITAKER DO NPI 1790923969


NPI Information

NPI: 1790923969
Provider Name: DR. BRUCE LEE WHITAKER, DO
Classification: Internal Medicine - 207RC0200X
Entity Type: Individual

Specialization: Critical Care Medicine

PECOS Registration: Yes

Address:
1350 WALTON WAY
AUGUSTA, GA
ZIP 30901
Phone: (706) 774-7745
Get Directions

DR. Bruce Lee Whitaker, DO is a critical care medicine internal medicine in Augusta, GA. The provider is an internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. DR. Bruce Lee Whitaker, DO NPI is 1790923969. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1350 WALTON WAY
AUGUSTA, GA
ZIP 30901-612
Phone: (706) 774-7745
Fax: (706) 774-5789

The NPI 1790923969 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/27/2009 and was last updated on 2/5/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine5101016483MICHIGANNo
2207RC0200XInternal MedicineCritical Care Medicine062124LOUISIANANo
3207RC0200XInternal MedicineCritical Care Medicine5101016483MICHIGANNo
4207RC0200XInternal MedicineCritical Care MedicineOC-0415IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10E00425OTHERMICHIGANBLUE CROSS BLUE SHIELD
21790923969MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.