Healthcare Provider Details

I. General information

NPI: 1083729933
Provider Name (Legal Business Name): JOSHUA M WHITE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W GREENLAWN
LANSING MI
48910
US

IV. Provider business mailing address

1031 E SAGINAW STREET
LANSING MI
48906
US

V. Phone/Fax

Practice location:
  • Phone: 231-843-2591
  • Fax:
Mailing address:
  • Phone: 517-487-1288
  • Fax: 517-487-1129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301082332
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: