MEDICARE: DR. DOUGLAS W WHITE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	2002008192	MO
2	207RR0500X	Rheumatology Physician	101752	GA
3	207RR0500X	Rheumatology Physician	53356	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316964836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS W WHITE MD

Provider Business Mailing Address
First Line	:	PO BOX 31665
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28231-1665
Country	:	US
Telephone Number	:	843-793-6980
Fax Number	:

Provider Business Practice Location Address
First Line	:	5885 GLENRIDGE DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-5512
Country	:	US
Telephone Number	:	843-572-4840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	10/29/2025

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Directions to “ DR. DOUGLAS W WHITE MD” Practice Location

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