MEDICARE: ALEXIS MARIE 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	2024-00377	NC

General Provider Information

NPI Number	:	1841876695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS MARIE WHITE MD

Provider Business Mailing Address
First Line	:	5826 SAMET DR STE 101
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-3661
Country	:	US
Telephone Number	:	336-878-6540
Fax Number	:

Provider Business Practice Location Address
First Line	:	5826 SAMET DR STE 101
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-3661
Country	:	US
Telephone Number	:	336-878-6540
Fax Number	:	336-878-6541

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

Provider Enumeration Date	:	03/22/2021
Last Update Date	:	10/10/2024

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