Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 29596 | AL |
Y | 207RI0011X | Interventional Cardiology | 29596 | AL |
NPI | 1003007980 |
---|---|
Provider Name | Juan Mario Bernal |
First Address | Birmingham, AL 35243-3407 |
Second Address | Birmingham, AL 35243-3407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 11/02/2016 |