Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 19296 | NC |
NPI | 1457338618 |
---|---|
Provider Name | Douglas Rector White |
First Address | Winston Salem, NC 27157 |
Second Address | Winston Salem, NC 27157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C87123 | (02) |