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Organization
GREENBRIER VALLEY ENT PLLC
Active
Organization
GREENBRIER VALLEY ENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER LEE WHITE D.O. (OWNER PHYSICIAN)
(304) 645-0870
Entity
Organization
Contact information
Practice address
118 TAYLOR LN, RONCEVERTE, WV 24970-1337
(304) 520-4991
Mailing address
PO BOX 902, LEWISBURG, WV 24901-0902
(304) 520-4991
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
—
NULL
207YS0123X
Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001916386
MTN ST BCBS
WV
01
—
1071033
BRICK STREET W/COMP
—
05
—
129458
—
WV
01
—
1306817689
UNISYS
WV
01
—
611994100
FEDERAL BLACK LUNG
—
01
—
7786898
AETNA
—
Enumeration date
11/15/2006
Last updated
03/17/2018
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