Healthcare Provider Details

I. General information

NPI: 1699976845
Provider Name (Legal Business Name): NZINGHA J WHITE D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 S 10TH AVE
SILER CITY NC
27344-2779
US

IV. Provider business mailing address

224 S 10TH AVE
SILER CITY NC
27344-2779
US

V. Phone/Fax

Practice location:
  • Phone: 919-663-1744
  • Fax: 919-663-0348
Mailing address:
  • Phone: 919-663-1744
  • Fax: 919-663-0348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2011-00054
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: