Provider Demographics
NPI:1124175922
Name:WHITE, EDWARD (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 CHURCH ST
Mailing Address - Street 2:SUITE 420
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2012
Mailing Address - Country:US
Mailing Address - Phone:615-329-2141
Mailing Address - Fax:
Practice Address - Street 1:2010 CHURCH ST
Practice Address - Street 2:SUITE 420
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2012
Practice Address - Country:US
Practice Address - Phone:615-329-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38142207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000065Medicaid
TNP00397818OtherRAILROAD MEDICARE PIN
TN3000065Medicaid
TNP00397818OtherRAILROAD MEDICARE PIN