Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 40481 | AL |
NPI | 1023495777 |
---|---|
Provider Name | Joseph Crivelli |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35249-7201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2015 |
Last Update Date | 10/08/2020 |