Provider Demographics
NPI:1245456706
Name:WHITE, CASSANDRA QUIANA (MD)
Entity type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:QUIANA
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 BROWNSTONE DR
Mailing Address - Street 2:917
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-9131
Mailing Address - Country:US
Mailing Address - Phone:706-303-8744
Mailing Address - Fax:706-303-8744
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0004
Practice Address - Country:US
Practice Address - Phone:706-721-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0683392086S0102X, 2086S0127X
GA68339208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery