MEDICARE: RALPH P WHITE JR. 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	207RP1001X	Pulmonary Disease Physician	35-03-6979	OH
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	35036979	OH

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	:	1508846114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RALPH P WHITE JR. MD

Provider Business Mailing Address
First Line	:	520 SOUTH MAIN ST
Second Line	:	SUITE 2446A
City	:	AKRON
State	:	OH
Zip	:	44311
Country	:	US
Telephone Number	:	330-253-7415
Fax Number	:	330-253-5260

Provider Business Practice Location Address
First Line	:	4125 MEDINA RD
Second Line	:	200 C
City	:	AKRON
State	:	OH
Zip	:	44333-2483
Country	:	US
Telephone Number	:	330-344-1260
Fax Number	:	330-666-2632

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	04/19/2013

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