Provider Demographics
NPI:1265404610
Name:WHITE, SHEILA M (OD)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:M
Last Name:WHITE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1410
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03802-1410
Mailing Address - Country:US
Mailing Address - Phone:603-436-4509
Mailing Address - Fax:603-431-5367
Practice Address - Street 1:38 DANIEL ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3899
Practice Address - Country:US
Practice Address - Phone:603-436-4509
Practice Address - Fax:603-431-5367
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH575152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1265404610OtherEBPA
NH0904169Y0NH01OtherBLUE CROSS BLUE SHEILD
NH1265404610OtherUNITED HEALTH CARE
NH9925868OtherCIGNA
NH1265404610OtherVISION SERVICE PLAN
NH27079OtherAVESIS
NH30003757Medicaid
NH1265404610OtherTRI CARE
NH1051349OtherHARVARD PILGRIM
NH1265404610OtherVISION SERVICE PLAN
NHU21272Medicare UPIN
NHRE185201Medicare PIN