Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 2301004936 | MI |
Y | 213ER0200X | Radiology | 2301004936 | MI |
NPI | 1356413033 |
---|---|
Provider Name | Dr. James W White JR. |
First Address | Flint, MI 48507-4747 |
Second Address | Flint, MI 48507-4747 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 13/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4433342 | (05) | MI |