Individual
DR. CHARLES HERMAN WHITE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9195
SC
207RP1001X
Pulmonary Disease Physician
9195
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091956
—
SC
01
—
5505332
AETNA
SC
01
—
AA68128552
MEDICARE PTAN
SC
01
—
P01416295
RAILROAD MEDICARE
SC
Enumeration date
02/09/2006
Last updated
11/02/2023
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