Provider Demographics
NPI:1003877234
Name:WHITE, MICHELLE H (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:H
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5690 DTC BLVD STE 130W
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3253
Mailing Address - Country:US
Mailing Address - Phone:303-500-5042
Mailing Address - Fax:303-872-6717
Practice Address - Street 1:5690 DTC BLVD STE 130W
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3253
Practice Address - Country:US
Practice Address - Phone:303-500-5042
Practice Address - Fax:303-872-6717
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0045241207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC571089770OtherTAX ID
SCGP2889Medicaid
CO77001532Medicaid
SC6598Medicare UPIN
COAA06126598Medicare PIN
CO77001532Medicaid
COC807965Medicare PIN