Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | 4301058077 | MI |
N | 207X00000X | Orthopaedic Surgeon | 4301058077 | MI |
NPI | 1215001730 |
---|---|
Provider Name | Nancy S. White |
First Address | Northville, MI 48167 |
Second Address | Northville, MI 48167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F88561 | (02) | |
NW058077 | CHAMPUS-CHAMPUS (01) | |
NW058077 | COMMERCIAL-COMMERCIAL NUMBER (01) |