Healthcare Provider Details

I. General information

NPI: 1003877234
Provider Name (Legal Business Name): MICHELLE H WHITE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5690 DTC BLVD STE 130W
GREENWOOD VILLAGE CO
80111-3253
US

IV. Provider business mailing address

5690 DTC BLVD STE 130W
GREENWOOD VILLAGE CO
80111-3253
US

V. Phone/Fax

Practice location:
  • Phone: 303-500-5042
  • Fax: 303-872-6717
Mailing address:
  • Phone: 303-500-5042
  • Fax: 303-872-6717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberDR0045241
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: