Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD.17705 | AL |
Y | 207SG0201X | Clinical Genetics (M.D.) | 17705 | AL |
N | 208000000X | Pediatrician | MD.17705 | AL |
N | 2080P0204X | Pediatric Emergency Doctor | MD.17705 | AL |
NPI | 1497786958 |
---|---|
Provider Name | Edward J Lose |
First Address | Birmingham, AL 35233-1711 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 23/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009935375 | (05) | AL |
009938832 | (05) | AL |
009938833 | (05) | AL |
009938834 | (05) | AL |
009938839 | (05) | AL |
009938842 | (05) | AL |
009938843 | (05) | AL |
009938844 | (05) | AL |
009953715 | (05) | AL |
051020867 | BLUE CROSS (01) | AL |
051106841 | BLUE CROSS (01) | AL |
051113380 | BLUE CROSS (01) | AL |
051520541 | BLUE CROSS (01) | AL |
051535390 | BLUE CROSS (01) | AL |
051535484 | BLUE CROSS (01) | AL |
051535486 | BLUE CROSS (01) | AL |
051535487 | BLUE CROSS (01) | AL |
051535501 | BLUE CROSS (01) | AL |
051535504 | BLUE CROSS (01) | AL |
051535507 | BLUE CROSS (01) | AL |
051535668 | BLUE CROSS (01) | AL |
051535671 | BLUE CROSS (01) | AL |
051543551 | BLUE CROSS (01) | AL |
051547020 | BLUE CROSS (01) | AL |
051590996 | BLUE CROSS (01) | AL |
051594923 | BLUE CROSS (01) | AL |
09922541 | (05) | MS |
105106 | (05) | AL |
105120 | (05) | AL |
125385 | (05) | AL |
142698 | (05) | AL |
148176 | (05) | AL |
511-30868 | BCBS (01) | AL |
511-36079 | BCBS (01) | AL |
9938838 | (05) | AL |
9938841 | (05) | AL |