Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 25943 | AL |
NPI | 1063404978 |
---|---|
Provider Name | Dr. Ali A M Hassoun |
First Address | Huntsville, AL 35801-3754 |
Second Address | Huntsville, AL 35801-3754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 10/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009970955 | (05) | AL |
I22022 | (02) | AL |