MEDICARE: DR. GEORGE MALCOLM WHITE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0105X	Surgery of the Hand (Surgery) Physician	ME0048920	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003890716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE MALCOLM WHITE M.D.

Provider Business Mailing Address
First Line	:	9212 POINT CYPRESS DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-5479
Country	:	US
Telephone Number	:	407-876-0626
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 N ORANGE AVE
Second Line	:	SUITE 600
City	:	ORLANDO
State	:	FL
Zip	:	32801-1026
Country	:	US
Telephone Number	:	407-841-2100
Fax Number	:	407-841-5705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	10/27/2011

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