Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 07071 | AL |
N | 111NI0900X | Internist | 07071 | AL |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 07071 | AL |
NPI | 1013072461 |
---|---|
Provider Name | Jorge Arturo Pino |
First Address | Birmingham, AL 35209-5709 |
Second Address | Birmingham, AL 35209-5709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 22/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000012121 | (05) | AL |
07071 | STATE MEDICAL LICENCE (01) | AL |
AP6347341 | FEDERAL DEA (01) | AL |
C73901 | (02) | AL |