Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 22399 | AL |
NPI | 1063511202 |
---|---|
Provider Name | Bindu Bennuri |
First Address | Northport, AL 35476 |
Second Address | Northport, AL 35476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 23/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009978015 | (05) | AL |
H99282 | (02) | AL |