Provider Demographics
NPI:1740397678
Name:NOTTINGHAM, CAROL WHITE (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:WHITE
Last Name:NOTTINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 GRESHAM DR
Mailing Address - Street 2:SUITE 811
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1901
Mailing Address - Country:US
Mailing Address - Phone:757-623-3845
Mailing Address - Fax:757-623-0547
Practice Address - Street 1:400 GRESHAM DR
Practice Address - Street 2:SUITE 811
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1901
Practice Address - Country:US
Practice Address - Phone:757-623-3845
Practice Address - Fax:757-623-0547
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035109207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB59590Medicare UPIN
VA160001347Medicare PIN