Provider Demographics
NPI:1225249386
Name:WHITE, DAVID ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:WHITE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:2 SHIRCLIFF WAY STE 600
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4762
Practice Address - Country:US
Practice Address - Phone:904-821-7556
Practice Address - Fax:855-707-1416
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12709207V00000X, 207VM0101X
VA0102203249207VM0101X
OH58-001675207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1225249386Medicaid
VAP01111933Medicare PIN
VAVV7547AMedicare PIN