Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 17829 | AL |
NPI | 1316924798 |
---|---|
Provider Name | Dr. Salem K David JR. |
First Address | Tuscaloosa, AL 35406-2287 |
Second Address | Tuscaloosa, AL 35406-2287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 26/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
158659 | (05) | AL |