Provider Demographics
NPI:1568680924
Name:WHITE, JAMES ALEXANDER (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALEXANDER
Last Name:WHITE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18215 FLOWER HILL WAY STE A
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-5393
Mailing Address - Country:US
Mailing Address - Phone:301-926-9100
Mailing Address - Fax:301-926-7545
Practice Address - Street 1:18215 FLOWER HILL WAY STE A
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-5393
Practice Address - Country:US
Practice Address - Phone:301-926-9100
Practice Address - Fax:301-926-7545
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01451111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD249169OtherMDIPA PROVIEDER NUMBER
MDM922OtherBC PROVIDER NUMBER
DCS835OtherBC PROVIDER NUMBER
MDE57003Medicare UPIN
MD613109Medicare ID - Type Unspecified