MEDICARE: ERIK D. WHITE D.O.

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	207P00000X	Emergency Medicine Physician	34-00-7070-W	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
2	000000374276	OTHER	OH	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1528038957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIK D. WHITE D.O.

Provider Business Mailing Address
First Line	:	4886 PAXTON RD
Second Line	:
City	:	COPLEY
State	:	OH
Zip	:	44321-1866
Country	:	US
Telephone Number	:	330-268-7844
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E STATE ST
Second Line	:
City	:	ALLIANCE
State	:	OH
Zip	:	44601-4936
Country	:	US
Telephone Number	:	330-596-6137
Fax Number	:	330-596-6130

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	07/08/2007

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Directions to “ ERIK D. WHITE D.O.” Practice Location

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