Provider Demographics
NPI:1841200268
Name:WHITE, MARTHA V (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:V
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11002 VEIRS MILL RD
Mailing Address - Street 2:414
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2574
Mailing Address - Country:US
Mailing Address - Phone:301-962-5800
Mailing Address - Fax:301-962-9585
Practice Address - Street 1:11002 VEIRS MILL RD
Practice Address - Street 2:414
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2574
Practice Address - Country:US
Practice Address - Phone:301-962-5800
Practice Address - Fax:301-962-9585
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0056193207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD27702OtherKAISER
MD423100OtherMAMSI
MD02-000154OtherUNITED HEALTHCARE
MD4349214OtherAETNA
MD423100OtherMAMSI
MD02-000154OtherUNITED HEALTHCARE