Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 00011996 | AL |
NPI | 1083619225 |
---|---|
Provider Name | Dr. Shashi A.m. Kumar |
First Address | Huntsville, AL 35801-6499 |
Second Address | Huntsville, AL 35801-6499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G26045 | (02) | AL |