Healthcare Provider Details

I. General information

NPI: 1831303205
Provider Name (Legal Business Name): ANDREA R WHITE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BROOKWOOD BLVD STE 50
BIRMINGHAM AL
35209-7802
US

IV. Provider business mailing address

513 BROOKWOOD BLVD STE 50
BIRMINGHAM AL
35209-7802
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-2730
  • Fax: 205-877-2399
Mailing address:
  • Phone: 205-877-2730
  • Fax: 205-877-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number27391
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number27391
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: