Provider Demographics
NPI:1033291422
Name:WHITE, KARA MICHELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:MICHELLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4607 MACCORKLE AVE SW
Mailing Address - Street 2:STE 400
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1364
Mailing Address - Country:US
Mailing Address - Phone:304-766-4400
Mailing Address - Fax:304-766-4417
Practice Address - Street 1:4607 MACCORKLE AVE SW
Practice Address - Street 2:STE 400
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1364
Practice Address - Country:US
Practice Address - Phone:304-766-4400
Practice Address - Fax:304-766-4417
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2068208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics