Provider Demographics
NPI:1518398536
Name:WHITE, ROBERT (M ED)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 OAKVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1316
Mailing Address - Country:US
Mailing Address - Phone:508-525-2762
Mailing Address - Fax:
Practice Address - Street 1:140 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3064
Practice Address - Country:US
Practice Address - Phone:508-222-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-01
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator