MEDICARE: DR. WARREN C WHITE M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	35229	NC

General Provider Information

NPI Number	:	1861537664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WARREN C WHITE M.D.

Provider Business Mailing Address
First Line	:	2606 IRON GATE DR
Second Line	:	SUITE 201
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2573
Country	:	US
Telephone Number	:	910-395-4441
Fax Number	:	910-395-7074

Provider Business Practice Location Address
First Line	:	2606 IRON GATE DR
Second Line	:	SUITE 201
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2573
Country	:	US
Telephone Number	:	910-395-4441
Fax Number	:	910-395-7074

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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