Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | ME-36498 | FL |
NPI | 1033117486 |
---|---|
Provider Name | Alan L Sallman |
First Address | Winter Haven, FL 33880-3053 |
Second Address | Winter Haven, FL 33880-3053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B90547 | (02) | FL |