Provider Demographics
NPI:1518051739
Name:WHITE, STEVEN MAXWELL (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MAXWELL
Last Name:WHITE
Suffix:
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 1:33 SOUTH FOOTHILL RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7745
Mailing Address - Country:US
Mailing Address - Phone:541-734-4648
Mailing Address - Fax:541-608-2896
Practice Address - Street 1:8495 CRATER LAKE HWY
Practice Address - Street 2:VA SOUTHERN OREGON REHAB CENTER AND CLINICS
Practice Address - City:WHITE CITY
Practice Address - State:OR
Practice Address - Zip Code:97503
Practice Address - Country:US
Practice Address - Phone:541-826-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19129208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice