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Individual

MR. MALCOLM DARRYL WHITE SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3603 KINGMAN AVE, PORTSMOUTH, VA 23707-4512
(757) 547-6629
(757) 638-1624
Mailing address
3603 KINGMAN AVE, PORTSMOUTH, VA 23707-4512
(757) 547-6629
(757) 638-1624

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
VA

Other

Enumeration date
09/16/2016
Last updated
09/16/2016
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