Provider Demographics
NPI:1366776619
Name:ANDREA R WHITE MD
Entity type:Organization
Organization Name:ANDREA R WHITE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-566-3337
Mailing Address - Street 1:2600 ARLINGTON AVE S
Mailing Address - Street 2:APT 49
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4167
Mailing Address - Country:US
Mailing Address - Phone:205-566-3337
Mailing Address - Fax:
Practice Address - Street 1:39 HANOVER CIR S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1703
Practice Address - Country:US
Practice Address - Phone:205-933-1828
Practice Address - Fax:205-933-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty