Healthcare Provider Details

I. General information

NPI: 1649910126
Provider Name (Legal Business Name): QIAOHUI WEI WHITE OD MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 10/07/2023
Certification Date: 10/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

2351 ERWIN ROAD DUMC BOX 3802
DURHAM NC
27710-7120
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-0424
  • Fax: 919-684-6096
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2685
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: