Healthcare Provider Details

I. General information

NPI: 1477257731
Provider Name (Legal Business Name): RICHARD JAMES WHITE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20020-7024
US

IV. Provider business mailing address

1331 4TH ST SE APT 616
WASHINGTON DC
20003-4460
US

V. Phone/Fax

Practice location:
  • Phone: 202-547-8450
  • Fax:
Mailing address:
  • Phone: 202-487-4265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: