Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 00027336 | AL |
NPI | 1033177340 |
---|---|
Provider Name | Dr. Srinivas Mallempati |
First Address | Birmingham, AL 35235-3134 |
Second Address | Birmingham, AL 35235-3134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 25/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I53479 | (02) | AL |