Dr. Mark Bruce Nissenbaum
Gastroenterologist
3701 Loop Rd Va Medical Center (679/11)
Tuscaloosa
, Alabama 35404-5015
Dr. Mark Bruce Nissenbaum
Gastroenterologist
3701 Loop Rd Va Medical Center (679/11)
Tuscaloosa
, Alabama 35404-5015
(205) 554-2034
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About
Features
Specialties
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Mark Bruce Nissenbaum
- 3701 Loop Rd Va Medical Center (679/11)
- Tuscaloosa, AL
- Zip : 35404-5015
- Fax : (205) 554-2034
- Phone : (205) 554-2000
Second Address
- Dr. Mark Bruce Nissenbaum
- 3701 Loop Rd Va Medical Center (679/11)
- Tuscaloosa, AL
- Zip : 35404-5015
- Fax : (205) 554-2034
- Phone : (205) 554-2000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0100X | Gastroenterologist | 122786 | NY |
National Provider Identifier
| NPI | 1003894502 |
|---|---|
| Provider Name | Dr. Mark Bruce Nissenbaum |
| First Address | Tuscaloosa, AL 35404-5015 |
| Second Address | Tuscaloosa, AL 35404-5015 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/01/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| OTH000 | (02) | AL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.