Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 32 | AL |
Y | 222Z00000X | Podiatrist | 32 | AL |
NPI | 1043298995 |
---|---|
Provider Name | Dr. Allen Howard Stern |
First Address | Montgomery, AL 36106-3609 |
Second Address | Montgomery, AL 36106-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/01/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32 | STATE LICENSE NUMBER (01) | AL |
T68904 | (02) | AL |