Healthcare Provider Details

I. General information

NPI: 1205877578
Provider Name (Legal Business Name): DANIEL R WHITE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2452 KIPLING AVENUE
CINCINNATI OH
45239-6650
US

IV. Provider business mailing address

5520 CHEVIOT ROAD
CINCINNATI OH
45247-7069
US

V. Phone/Fax

Practice location:
  • Phone: 513-681-7800
  • Fax: 513-853-3045
Mailing address:
  • Phone: 513-451-4033
  • Fax: 513-451-4118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35058268
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35-058268
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: