Individual
SAMUEL C WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 UNION ST, EVANSVILLE, WI 53536-1175
(608) 882-5613
(608) 882-6339
Mailing address
300 UNION ST, EVANSVILLE, WI 53536-1175
(608) 882-5613
(608) 882-6339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50076
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WHITESAM
MERCYCARE INSURANCE
WI
Enumeration date
01/31/2007
Last updated
11/08/2011
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