Individual
KERMIT E WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28430 HERNDONWOOD DRIVE, FARMINGTON HILLS, MI 48334
(248) 504-9723
Mailing address
28430 HERNDONWOOD DRIVE, FARMINGTON HILLS, MI 48334
(248) 504-9723
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301062752
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000081497
ANTHEM
IN
05
—
200144090
—
IN
01
—
Q0086502
SHO
—
Enumeration date
12/28/2005
Last updated
05/21/2020
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