Individual provider · Type 1 NPI

Daniel T. Whitted, PA-C

Medical Physician Assistant · Boise, ID

NPI number 1942590914 Active

Practice location

6590 W Norwood Dr
Boise, ID 83704-8765

Fax (208) 855-0157

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA-884 (ID)
Surgical Physician Assistant 363AS0400XPA-884 (ID)

Medical Physician Assistant: Definition to come...

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About NPI 1942590914

Daniel T. Whitted, PA-C's National Provider Identifier is 1942590914, issued on Apr 12, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Boise, ID. The record was last updated on Apr 12, 2011.