Provider Demographics
NPI:1619993656
Name:ROBINSON WHITE, MIA JANICE (MD)
Entity Type:Individual
Prefix:MRS
First Name:MIA
Middle Name:JANICE
Last Name:ROBINSON WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MIA
Other - Middle Name:JANICE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3495 PIEDMONT ROAD, NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:
Practice Address - Street 1:2525 CUMBERLAND PARKWAY
Practice Address - Street 2:KAISER PERMENENTE CUMBERLAND MEDICAL CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:770-431-4145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0550072084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAI12922Medicare UPIN