Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 00019447 | AL |
NPI | 1033182241 |
---|---|
Provider Name | Dr. Nicolisa D Massie |
First Address | Homewood, AL 35209-5603 |
Second Address | Homewood, AL 35209-5603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 24/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009940783 | (05) | AL |
0366100001 | CIGNA GOVERNMENT SERVICES PTAN (01) | AL |
0366100001 | MC NSC (01) | AL |
1911001 | UNITED HEALTHCARE (01) | AL |
3069868001 | CIGNA (01) | AL |
51096368 | MEDICARE (01) | AL |
7693171 | AETNA (01) | AL |
D815 | MEDICARE GROUP PIN (01) | AL |
H17904 | (02) | |
H17904 | HEALTH SPRINGS (01) | AL |
H17904 | VIVA (01) | AL |