Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | D0064064 | MD |
NPI | 1003859109 |
---|---|
Provider Name | Alex L Mah |
First Address | Salisbury, MD 21804-5259 |
Second Address | Salisbury, MD 21801-5422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 04/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I54662 | (02) | MD |
P00397120 | RAILROAD MEDICARE (01) | MD |