Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD.29290 | AL |
N | 208000000X | Pediatrician | MD.29290 | AL |
Y | 2080P0204X | Pediatric Emergency Doctor | MD.29290 | AL |
NPI | 1174726160 |
---|---|
Provider Name | Heather F Mitchell |
First Address | Birmingham, AL 35294-0001 |
Second Address | Birmingham, AL 35233-1711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 24/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118165 | (05) | AL |
118803 | (05) | AL |
511-05286 | BCBS (01) | AL |
511-06544 | BCBS (01) | AL |
Z10929 | VIVA HEALTH (01) | AL |