Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 19723 | AL |
N | 111NI0900X | Internist | 19723 | AL |
Y | 207RI0200X | Infectious Disease | 19723 | AL |
NPI | 1043256829 |
---|---|
Provider Name | Maria Rosario Abano Cumagun |
First Address | Birmingham, AL 35205-1601 |
Second Address | Hoover, AL 35244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 05/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000096053 | (05) | AL |
009914208 | (05) | AL |
510I110191 | MEDICARE PTAN (01) | AL |
51545897 | BCBS (01) | AL |
G25228 | (02) | AL |