Provider Demographics
NPI:1487257226
Name:ANNE WHITE MD PLLC
Entity type:Organization
Organization Name:ANNE WHITE MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:HUGHES
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-884-5656
Mailing Address - Street 1:50505 SCHOENHERR RD STE 350
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3140
Mailing Address - Country:US
Mailing Address - Phone:586-884-5656
Mailing Address - Fax:
Practice Address - Street 1:25200 LITTLE MACK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2116
Practice Address - Country:US
Practice Address - Phone:586-884-5656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNE WHITE MD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-16
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty