Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD.38649 | AL |
Y | 2080P0204X | Pediatric Emergency Doctor | MD.38649 | AL |
NPI | 1013414911 |
---|---|
Provider Name | Austin Ryan Wheeler |
First Address | Birmingham, AL 35233-1711 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2018 |
Last Update Date | 09/08/2021 |