Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 047378 | GA |
NPI | 1245230390 |
---|---|
Provider Name | Karyn E White |
First Address | Cheverly, MD 20785-1189 |
Second Address | Cheverly, MD 20785-1189 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 16/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000936724 | (05) | GA |
H76247 | (02) |