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Individual
MR. KEVIN MICHAEL WHITE
Active
Individual
MR. KEVIN MICHAEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-00761
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-00761
STATE LICENSE NUMBER
NC
Enumeration date
12/16/2005
Last updated
10/22/2012
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