Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | D0325 | AL |
NPI | 1538195961 |
---|---|
Provider Name | Dr. Blane Edward Bateman |
First Address | Anniston, AL 36207 |
Second Address | Anniston, AL 36207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 15/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000088345 | (05) | AL |
F08624 | (02) |