Basic Information
| Provider Information | |||||||||
| NPI: | 1669630893 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALLIERE-WHITE | ||||||||
| FirstName: | TAI | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2727 PACES FERRY RD SE STE 1-1100 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303396151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709224024 | ||||||||
| FaxNumber: | 7702292111 | ||||||||
| Practice Location | |||||||||
| Address1: | 688 SPRING ST NW | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303081934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6784228824 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2008 | ||||||||
| LastUpdateDate: | 07/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086X0206X | 072510 | GA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | 208600000X | 072510 | GA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.