Provider Demographics
NPI:1245230390
Name:WHITE, KARYN E (MD)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:E
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3001 HOSPITAL DR
Mailing Address - Street 2:PERINATAL DIAGNOSTIC CENTER
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1189
Mailing Address - Country:US
Mailing Address - Phone:301-618-3542
Mailing Address - Fax:301-618-3374
Practice Address - Street 1:3001 HOSPITAL DR
Practice Address - Street 2:PERINATAL DIAGNOSTIC CENTER
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1189
Practice Address - Country:US
Practice Address - Phone:301-618-3542
Practice Address - Fax:301-618-3374
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA047378207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000936724Medicaid
GA16BBBXCMedicare ID - Type Unspecified
H76247Medicare UPIN