Individual
MRS. MATTIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3197 PORTIS AVE, SAINT LOUIS, MO 63116-2023
(618) 713-3847
Mailing address
3197 PORTIS AVE, SAINT LOUIS, MO 63116-2023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036103546
IL
207Q00000X
Family Medicine Physician
Primary
2008014947
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103546
—
IL
01
—
10007459
BCBS GROUP NUMBER
IL
05
—
1316912892
—
MO
01
—
460661
HEALTHLINK PROV NUMBER
IL
01
—
659580
MEDICARE GROUP
IL
01
—
CB3700
RAILROAD GROUP NUMBER
IL
01
—
K04489
UMWA PIN
IL
01
—
P00189155
RAILROAD MEDICARE
IL
Enumeration date
02/20/2006
Last updated
10/17/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us