Provider Demographics
NPI:1295718930
Name:WHITE, MARY A BARTAS (DO)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:A BARTAS
Last Name:WHITE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3 FLOWERS DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-1701
Mailing Address - Country:US
Mailing Address - Phone:717-612-1830
Mailing Address - Fax:717-612-1810
Practice Address - Street 1:3 FLOWERS DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1701
Practice Address - Country:US
Practice Address - Phone:717-612-1830
Practice Address - Fax:717-612-1850
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS007069L2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014063880005Medicaid
PA0014063880005Medicaid
E79274Medicare UPIN