Provider Demographics
NPI:1073801106
Name:WHITE, NICHOLAS R (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:R
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1498 FREEDOM BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6077
Mailing Address - Country:US
Mailing Address - Phone:843-676-2720
Mailing Address - Fax:843-676-2722
Practice Address - Street 1:1498 FREEDOM BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6077
Practice Address - Country:US
Practice Address - Phone:843-676-2720
Practice Address - Fax:843-676-2722
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC338852086S0105X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery