Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 068339 | GA |
Y | 2086S0127X | Trauma Surgeon | 068339 | GA |
NPI | 1245456706 |
---|---|
Provider Name | Dr. Cassandra Quiana White |
First Address | Evans, GA 30809-9131 |
Second Address | Augusta, GA 30912-0004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 09/08/2021 |