Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MD.19945 | AL |
NPI | 1134156441 |
---|---|
Provider Name | Martin J Heslin |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36604-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 22/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000036912 | (05) | AL |
000036912 | BLUE CROSS (01) | AL |
020032307 | RAILROAD MEDICARE (01) | AL |
F91062 | VIVA (01) | AL |