Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 22204 | WV |
N | 207YS0123X | Facial Plastic Surgeon | 200200300 | NC |
NPI | 1306817689 |
---|---|
Provider Name | Mr. Christopher L White |
First Address | Lewisburg, WV 24901-9302 |
Second Address | Lewisburg, WV 24901-9674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 23/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129458 | MEDICAID UNICARE (01) | WV |
2344771 | GROUP MEDICARE (01) | NC |
3810007432 | (05) | WV |
4198581 | (02) | WV |
5901335 | (05) | NC |
I38033 | (02) |