MEDICARE: DR. MARIELA G WHITE MD

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	207Q00000X	Family Medicine Physician	35.144173	OH
2	390200000X	Student in an Organized Health Care Education/Training Program		TX

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	:	1447814876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIELA G WHITE MD

Provider Business Mailing Address
First Line	:	231 SEASONS RD STE 300
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44224-1069
Country	:	US
Telephone Number	:	303-662-5666
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 SEASONS RD STE 300
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44224-1069
Country	:	US
Telephone Number	:	303-662-5666
Fax Number	:

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

Provider Enumeration Date	:	05/01/2019
Last Update Date	:	10/18/2024

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Directions to “ DR. MARIELA G WHITE MD” Practice Location

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