Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 28464 | AL |
Y | 204F00000X | Transplant Surgeon | 81933 | SC |
NPI | 1811101538 |
---|---|
Provider Name | Dr. Jared Adam White |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 15/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051116813 | BCBS (01) | AL |
051116814 | BCBS (01) | AL |
051116815 | BCBS (01) | AL |
051116816 | BCBS (01) | AL |
08389333 | (05) | MS |
128476 | (05) | AL |
128477 | (05) | AL |
128478 | (05) | AL |
129530 | (05) | AL |