Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 42265 | AL |
NPI | 1396273330 |
---|---|
Provider Name | Elizabeth Tejblum Evans |
First Address | Birmingham, AL 35233-3110 |
Second Address | Birmingham, AL 35233-3110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2017 |
Last Update Date | 18/06/2021 |