Provider Demographics
NPI:1003890716
Name:WHITE, GEORGE MALCOLM (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MALCOLM
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 POINT CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5479
Mailing Address - Country:US
Mailing Address - Phone:407-876-0626
Mailing Address - Fax:
Practice Address - Street 1:801 N ORANGE AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1026
Practice Address - Country:US
Practice Address - Phone:407-841-2100
Practice Address - Fax:407-841-5705
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00489202086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD55190Medicare UPIN
FL47816YMedicare ID - Type Unspecified