Individual
DR. MARK PHILIP WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
RR #1 BOX 1000, GREENE COUNTY GENERAL, LINTON, IN 47441-9457
(812) 847-2281
Mailing address
3309 E MULBERRY CT, BLOOMINGTON, IN 47401-2425
(812) 331-2709
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01038810A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000594833
BLUE SHIELD
IN
05
—
100468280 D
—
IN
Enumeration date
09/21/2006
Last updated
02/12/2009
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