| Organization Name: | KERMIT E. WHITE MD PC |
| NPI Number: | 1164784815 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KERMIT WHITE (OWNER) |
| Mailing Address: | 33000 Covington Club Dr Apt 1 Farmington Hills |
| State: | MI US |
| Postal Code: | 483341647 |
| Phone Number: | 2485049723 |
| Fax Number: | |
| NPI Enumeration Date: | 06/08/2012 |
| NPI Last Update Date: | 06/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |