Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | A119600 | CA |
N | 207P00000X | Emergency Physician | D0073749 | MD |
N | 207P00000X | Emergency Physician | M-2141 | GU |
Y | 207P00000X | Emergency Physician | MD29152 | AL |
N | 207P00000X | Emergency Physician | MD432398 | PA |
N | 207P00000X | Emergency Physician | ME100506 | FL |
N | 207PE0004X | Emergency Medical Services | MD432398 | PA |
NPI | 1093906406 |
---|---|
Provider Name | Dr. Rebecca Kay Carney Calisch |
First Address | Fairhope, AL 36532-1812 |
Second Address | Fairhope, AL 36532-1812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2007 |
Last Update Date | 16/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102023900 | (05) | PA |
1020239000001 | PROMISE (01) | PA |
1093906406 | (05) | AL |
1093906406 | NPI (01) | AL |
281342400 | (05) | FL |
36243 | BLUE CROSS BLUE SHIELD (01) | FL |
A11960 | LICENSE (01) | CA |
D0073749 | STATE LICENSE (01) | MD |
P00622516 | RAILROAD MEDICARE (01) | FL |