Healthcare Provider Details

I. General information

NPI: 1982946216
Provider Name (Legal Business Name): RENITA FELICIA WHITE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5780 PEACHTREE DUNWOODY RD STE 320
ATLANTA GA
30342-1575
US

IV. Provider business mailing address

5780 PEACHTREE DUNWOODY RD STE 300
ATLANTA GA
30342-1513
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-2943
  • Fax: 404-256-6027
Mailing address:
  • Phone: 404-303-8035
  • Fax: 404-303-1325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number078338
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: