Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 29280 | AL |
N | 2084N0600X | Clinical Neurophysiologist | 29280 | AL |
NPI | 1013110006 |
---|---|
Provider Name | Dr. William Edward Lievens |
First Address | Montgomery, AL 36111-1529 |
Second Address | Montgomery, AL 36117-1935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 14/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102I375480 | (02) | AL |
12562126 | CAQH (01) | AL |
150070 | (05) | AL |
29280 | ALABAMA STATE BOARD OF MEDICAL EXAMINERS, CONTROLLED SUBSTANCES REGISTRATION (01) | AL |
3634532 | UNITED HEALTH CARE (01) | AL |
4448615 | CIGNA (01) | AL |
511-36880 | BLUE ADVANTAGE (01) | AL |
511-36880 | BLUE CROSS/BLUE SHIELD OF ALABAMA (01) | AL |
57026 | BOARD CERTIFIED IN NEUROLOGY, AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY (01) | |
FL1311113 | DEA CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE, US DEPARTMENT OF JUSTICE (01) | AL |
MD.29280 | ALABAMA MEDICAL LICENSURE COMMISSION (01) | AL |
XXXXX9748 | TRICARE / HUMANA MILITARY (01) | AL |