Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD.20968 | AL |
NPI | 1003926270 |
---|---|
Provider Name | Charles R Law |
First Address | Birmingham, AL 35211-5965 |
Second Address | Birmingham, AL 35211-5965 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 06/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009948670 | (05) | AL |
06989317 | (05) | MS |
131757 | (05) | AL |
511-17174 | BCBS (01) | AL |
G40410 | (02) | |
G40410 | VIVA HEALTH (01) | AL |