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General NPI Number Information
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NPI Number | 1831585710
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Entity Type | Individual
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Provider Name | MATTHEW J WHITE D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 1500 PONTIAC AVE STE 107
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City | CRANSTON
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State | RI
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Zip | 02920-4486
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Country | US
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Telephone | 401-606-1620
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Fax |
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Provider Business Mailing Address
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Address Line | 117 ELLENFIELD ST STE 101
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City | PROVIDENCE
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State | RI
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Zip | 02905-4541
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Country | US
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Telephone | 401-444-6779
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 20769
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | DO01093
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License Number State | RI
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