Provider Demographics
NPI:1831539253
Name:WHITE, ANDREW WESLEY (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WESLEY
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 1:1120 15TH ST # AF1006
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:229-869-2466
Mailing Address - Fax:
Practice Address - Street 1:1120 15TH ST # AF1006
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-4500
Practice Address - Country:US
Practice Address - Phone:229-869-2466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-2731208600000X
GA74619207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No208600000XAllopathic & Osteopathic PhysiciansSurgery