Individual
BEAU RANDOLPH WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LEE ST BOX 801016, CHARLOTTESVILLE, VA 22908-0001
(434) 924-2663
(434) 244-4454
Mailing address
1479 GRAY STONE CT, CHARLOTTESVILLE, VA 22902-8793
(252) 230-5547
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0116040797
VA
390200000X
Student in an Organized Health Care Education/Training Program
261467
NC
Other
Enumeration date
05/05/2020
Last updated
07/25/2025
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