Provider Demographics
NPI:1407232879
Name:WHITE, ANDREW STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEVEN
Last Name:WHITE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W LAKE LANSING RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1438
Mailing Address - Country:US
Mailing Address - Phone:517-337-8182
Mailing Address - Fax:517-332-0038
Practice Address - Street 1:310 W LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1438
Practice Address - Country:US
Practice Address - Phone:517-337-8182
Practice Address - Fax:517-332-0038
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004929152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist