Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 27723 | AL |
N | 111NI0900X | Internist | 27723 | AL |
Y | 207RI0011X | Interventional Cardiology | 27723 | AL |
NPI | 1114139300 |
---|---|
Provider Name | Edward Ashley Carraway |
First Address | Tuscaloosa, AL 35401-7428 |
Second Address | Tuscaloosa, AL 35401-7428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 30/04/2014 |