Provider Demographics
NPI:1639287717
Name:WHITE, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:326 COLUMBUS CORNERS DR
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-4929
Mailing Address - Country:US
Mailing Address - Phone:910-212-6613
Mailing Address - Fax:910-267-8986
Practice Address - Street 1:326 COLUMBUS CORNERS DR
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4929
Practice Address - Country:US
Practice Address - Phone:910-212-6613
Practice Address - Fax:910-267-8986
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2014-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200401681207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89138TTMedicaid