Individual
DONALD WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
740 DUNLAWTON AVE, PORT ORANGE, FL 32127-4901
(386) 763-1000
Mailing address
PO BOX 9671, DAYTONA BEACH, FL 32120-9671
(386) 615-4015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME41119
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267877000
—
FL
01
—
79747
BCBS
FL
01
—
P00049836
RAILROAD MEDICARE
FL
01
—
VHN
ME0041119
FL
Enumeration date
03/15/2006
Last updated
02/23/2011
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