Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | ME0048920 | FL |
NPI | 1003890716 |
---|---|
Provider Name | Dr. George Malcolm White |
First Address | Orlando, FL 32836-5479 |
Second Address | Orlando, FL 32801-1026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 27/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D55190 | (02) | FL |