Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 24922 | AL |
NPI | 1073589388 |
---|---|
Provider Name | Dr. Susan Iskandrian Buckingham |
First Address | Birmingham, AL 35249-6805 |
Second Address | Birmingham, AL 35233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 17/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051513571 | BLUE SHIELD OF AL. (01) | AL |
303709373 | (05) | AL |
303719373 | (05) | AL |
303739373 | (05) | AL |
303749373 | (05) | AL |
303769373 | (05) | AL |
303799373 | (05) | AL |
51005675 | BLUE SHIELD OF AL. (01) | AL |
51005676 | BLUE SHIELD OF AL. (01) | AL |
51005681 | BLUE SHIELD OF AL. (01) | AL |
H74186 | (02) | AL |