Individual
DR. MARK TIMOTHY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1338 HIGHWAY 14, SIMPSONVILLE, SC 29681-5637
(864) 297-7091
Mailing address
1338 HIGHWAY 14, SIMPSONVILLE, SC 29681-5637
(864) 297-7091
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15006
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2352
—
SC
Enumeration date
01/26/2006
Last updated
10/30/2014
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