Provider Demographics
NPI:1457339335
Name:WHITE, DEBRA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANN
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:HOLIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:275 SANDWICH ST
Mailing Address - Street 2:C/O CATHY GREY
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2183
Mailing Address - Country:US
Mailing Address - Phone:508-830-2390
Mailing Address - Fax:508-830-2399
Practice Address - Street 1:275 SANDWICH ST
Practice Address - Street 2:C/O CATHY GREY
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2183
Practice Address - Country:US
Practice Address - Phone:508-830-2390
Practice Address - Fax:508-830-2399
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219975207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA469665OtherTUFTS HEALTH PLAN
MAJ27968OtherBCBSMA
MA2078333Medicaid
MAAA17166OtherHARVARD PILGRIM
MA469665OtherTUFTS HEALTH PLAN
MAA37414Medicare PIN