MEDICARE: THOMAS R 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	207Q00000X	Family Medicine Physician	26410	NC

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	:	1568485365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS R WHITE MD

Provider Business Mailing Address
First Line	:	301 E. MAIN STREET PO BOX 1088
Second Line	:	SUITE 1
City	:	CHERRYVILLE
State	:	NC
Zip	:	28021
Country	:	US
Telephone Number	:	704-678-3221
Fax Number	:	704-802-4551

Provider Business Practice Location Address
First Line	:	301 E. MAIN STREET
Second Line	:	SUITE 1
City	:	CHERRYVILLE
State	:	NC
Zip	:	28021
Country	:	US
Telephone Number	:	704-678-3221
Fax Number	:	704-802-4551

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	11/20/2023

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