Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD.41894 | AL |
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD.41894 | AL |
NPI | 1013439124 |
---|---|
Provider Name | Dr. Vivek Vishwanath Shukla |
First Address | Birmingham, AL 35233-1802 |
Second Address | Birmingham, AL 35233-1802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2017 |
Last Update Date | 28/04/2021 |