Individual
MATTIE DAVIS WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2041 MARTIN LUTHER KING JR AVE SE STE 239, WASHINGTON, DC 20020-7034
(202) 547-8450
Mailing address
2041 MARTIN LUTHER KING JR AVE SE STE 239, WASHINGTON, DC 20020-7034
(202) 547-4850
(202) 610-7147
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D0037605
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092200900
—
DC
01
—
2084P0804X
TAXONOMY CODE
DC
Enumeration date
02/15/2007
Last updated
10/17/2022
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