Provider Demographics
NPI:1508846114
Name:WHITE, RALPH P JR (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:P
Last Name:WHITE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 SOUTH MAIN ST
Mailing Address - Street 2:SUITE 2446A
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311
Mailing Address - Country:US
Mailing Address - Phone:330-253-7415
Mailing Address - Fax:330-253-5260
Practice Address - Street 1:4125 MEDINA RD
Practice Address - Street 2:200 C
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2483
Practice Address - Country:US
Practice Address - Phone:330-344-1260
Practice Address - Fax:330-666-2632
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-03-6979207RP1001X
OH35036979207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0636391Medicaid
0446575Medicare PIN
0446573Medicare PIN
0446574Medicare PIN
0446576Medicare PIN
OH0636391Medicaid
0446577Medicare PIN