Provider Demographics
NPI:1841876695
Name:WHITE, ALEXIS MARIE (MD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MARIE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5826 SAMET DR STE 101
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-3661
Mailing Address - Country:US
Mailing Address - Phone:336-878-6540
Mailing Address - Fax:
Practice Address - Street 1:5826 SAMET DR STE 101
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3661
Practice Address - Country:US
Practice Address - Phone:336-878-6540
Practice Address - Fax:336-878-6541
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2024-00377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program