Healthcare Provider Details

I. General information

NPI: 1508846114
Provider Name (Legal Business Name): RALPH P WHITE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 MEDINA RD 200 C
AKRON OH
44333-2483
US

IV. Provider business mailing address

520 SOUTH MAIN ST SUITE 2446A
AKRON OH
44311
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-1260
  • Fax: 330-666-2632
Mailing address:
  • Phone: 330-253-7415
  • Fax: 330-253-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35036979
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35-03-6979
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: