Individual
GEORGE EDWARD WHITE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0EG001408
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048822000
KEYSTONE HEALTH PLAN EAST
—
01
—
037493
BLUE SHIELD
—
Enumeration date
07/11/2006
Last updated
01/22/2013
Update your record
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