Provider Demographics
NPI:1427155167
Name:WHITE, ROBERT M (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:856-968-8366
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERISTY RADIOLOGY
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2382
Practice Address - Fax:856-365-0472
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2007-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA566172085R0202X
PAMD034427E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ677887SF5Medicare ID - Type Unspecified
E49953Medicare UPIN