Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | D0039257 | MD |
NPI | 1073522132 |
---|---|
Provider Name | Jonathan L White |
First Address | Owings Mills, MD 21117 |
Second Address | Rockville, MD 20850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 08/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063461100 | (05) | MD |
170781700 | (05) | MD |
F54191 | (02) |