Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 10510 | AL |
Y | 207VG0400X | Gynecologist | 10510 | AL |
NPI | 1508819145 |
---|---|
Provider Name | Dr. Earl Wimberly Stradtman JR. |
First Address | Birmingham, AL 35205-1200 |
Second Address | Birmingham, AL 35205-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 05/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000024910 | (05) | AL |
C75043 | (02) | AL |