Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 01030755A | IN |
NPI | 1144283151 |
---|---|
Provider Name | Dr. Robert Dennis White |
First Address | South Bend, IN 46601-1033 |
Second Address | South Bend, IN 46601-1033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 08/07/2007 |