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General NPI Number Information
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NPI Number | 1881854743
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Entity Type | Organization
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Legal Business Name | VICTORIA Y. WARNER-WHITE M.D.
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 2040 DAN PROCTOR DR SUITE 230
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City | SAINT MARYS
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State | GA
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Zip | 31558-3811
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Country | US
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Telephone | 912-576-6464
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Fax | 912-576-6460
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Provider Business Mailing Address
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Address Line | 2040 DAN PROCTOR DR SUITE 230
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City | SAINT MARYS
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State | GA
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Zip | 31558-3811
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Country | US
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Telephone | 912-576-6464
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Fax | 912-576-6460
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. VICTORIA YALONDA WARNER-WHITE
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Credential | M.D.
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Telephone | 912-576-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 039504
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License Number State | GA
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