Provider Demographics
NPI:1932495215
Name:WHITE, CANDACE CHARYSSE (DO, MPH, MS)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:CHARYSSE
Last Name:WHITE
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Gender:F
Credentials:DO, MPH, MS
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Mailing Address - Street 1:2745 DEKALB MEDICAL PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-4933
Mailing Address - Country:US
Mailing Address - Phone:770-593-2382
Mailing Address - Fax:678-514-2527
Practice Address - Street 1:2745 DEKALB MEDICAL PKWY STE 110
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4933
Practice Address - Country:US
Practice Address - Phone:770-593-2382
Practice Address - Fax:678-514-2527
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2018-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA75713207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine