Healthcare Provider Details

I. General information

NPI: 1386176972
Provider Name (Legal Business Name): WILLIAM BRANDON WHITE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MEDICAL CENTER DR STE 3300
BRUNSWICK ME
04011-2674
US

IV. Provider business mailing address

121 MEDICAL CENTER DR STE 3300
BRUNSWICK ME
04011-2674
US

V. Phone/Fax

Practice location:
  • Phone: 207-373-6490
  • Fax: 207-536-6046
Mailing address:
  • Phone: 207-373-6490
  • Fax: 207-536-6046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC20013214
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberDO3683
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberDO3683
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO3683
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: