Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 10042 | AL |
NPI | 1962496638 |
---|---|
Provider Name | Dr. Donald Cantley |
First Address | Birmingham, AL 35246-0100 |
Second Address | Alabaster, AL 35007-8824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E45260 | (02) | AL |