Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 31582 | AL |
Y | 2081S0010X | Sports Medicine | 31582 | AL |
Y | 213ES0000X | Sports Medicine | 31582 | AL |
NPI | 1073760831 |
---|---|
Provider Name | Dr. Ricardo E. Colberg |
First Address | Birmingham, AL 35205-1638 |
Second Address | Birmingham, AL 35205-1638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2008 |
Last Update Date | 27/12/2019 |