Individual ProviderJohn Douglas WhiteInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address8720 Crider Brook Way, Potomac, MD 20854-4547(202) 906-0788PECOS EnrollmentBased on the most recent information from CMS, provider John Douglas White does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1598866402Provider TypeIndividualFull NameWhite, John DouglasCredentialMDGenderMaleSole ProprietorNoEnumeration Date9/25/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address8720 Crider Brook Way, Potomac, MD 20854-4547Phone(202) 906-0788Fax(301) 469-7138Mailing LocationMailing Address8720 Crider Brook Way, Potomac, MD 20854-4547Phone(202) 906-0788Fax(301) 469-7138Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseD0041123MarylandCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense0101053484Virginia