Provider Demographics
NPI:1306079199
Name:MD WELLNESS AND WEIGHT MANAGEMENT, PLLC
Entity type:Organization
Organization Name:MD WELLNESS AND WEIGHT MANAGEMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-291-3957
Mailing Address - Street 1:2606 IRON GATE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2494
Mailing Address - Country:US
Mailing Address - Phone:877-291-3957
Mailing Address - Fax:910-332-1048
Practice Address - Street 1:3352 WEST FRIENDLY AVENUE
Practice Address - Street 2:SUITE 125
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4806
Practice Address - Country:US
Practice Address - Phone:877-291-3957
Practice Address - Fax:910-332-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center