Provider Demographics
NPI:1003815234
Name:WHITE, ANNE HUGHES (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:HUGHES
Last Name:WHITE
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 1:25200 LITTLE MACK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2116
Mailing Address - Country:US
Mailing Address - Phone:586-884-5656
Mailing Address - Fax:586-884-5674
Practice Address - Street 1:25200 LITTLE MACK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2116
Practice Address - Country:US
Practice Address - Phone:586-884-5656
Practice Address - Fax:586-884-5674
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059514207K00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3454642Medicaid
MI120341OtherPREFERRED CHOICES
MI5844552OtherAETNA
MIC5746OtherM-CARE
MI50153146OtherHAP
MI0502784OtherBLUE CROSS AND BLUE SHIELD
MI3454642Medicaid
MI120341OtherPREFERRED CHOICES