Provider Demographics
NPI:1871519629
Name:WHITE, MARGARET ANNE (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANNE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 ANGELIQUE DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1202
Mailing Address - Country:US
Mailing Address - Phone:404-636-4881
Mailing Address - Fax:833-705-0222
Practice Address - Street 1:1626 JEURGENS CT
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-2219
Practice Address - Country:US
Practice Address - Phone:770-806-6818
Practice Address - Fax:770-510-1557
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036482207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF42038Medicare UPIN