Provider Demographics
NPI:1770535353
Name:WHITE, LINDSEY L (MD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:L
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 N ROAD ST
Mailing Address - Street 2:BLDG. 9
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3365
Mailing Address - Country:US
Mailing Address - Phone:252-338-9451
Mailing Address - Fax:252-338-9170
Practice Address - Street 1:1134 N ROAD ST
Practice Address - Street 2:BLDG. 9
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3365
Practice Address - Country:US
Practice Address - Phone:252-338-9451
Practice Address - Fax:252-338-9170
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29686207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-0156MMedicaid
2147172-CMedicare PIN
E39647Medicare UPIN
NC110104609Medicare PIN