Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 36003106 | OH |
NPI | 1093884033 |
---|---|
Provider Name | Dr. Robert J White |
First Address | Lorain, OH 44053-2136 |
Second Address | Lorain, OH 44053-2136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 22/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000230200 | ANTHEM BC/BS (01) | OH |
04374 | KAISER PERM. (01) | OH |
2116534 | (05) | OH |
21203 | QUALCHOICE (01) | OH |
30005720700 | BWC (01) | OH |
300057207027 | CARESOURCE (01) | OH |
480033907 | RAILROAD MEDICARE (01) | OH |
7361316 | AETNA (01) | OH |
E03106 | SUMMA (01) | OH |
U74952 | (02) |