White, David A

White, David A is an individual health care provider with primary practice located at 24988 Se Stark St Ste 220 , Gresham OR 97030-8324. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. White, David A can be contacted via phone (503) 674-1580.

Contact Information

Primary practice address
24988 Se Stark St Ste 220 Gresham OR 97030-8324
Phone: (503) 674-1580
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD218730 Oregon
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 19950 Oklahoma

Profile Details

NPI number 1194769513
LBN Legal business name White, David A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Feb 29th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194769513 NPPES
Indiana MEDICAID 200442000
Indiana MEDICAID 200606660A
Indiana MEDICAID 100037900A
Indiana Other 000000287113
Indiana MEDICAID 100180890G
Indiana Other CH6490

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