Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | L3175R | AL |
NPI | 1366762239 |
---|---|
Provider Name | Martin Lacher |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2010 |
Last Update Date | 25/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051108287 | BLUE CROSS (01) | AL |
051108288 | BLUE CROSS (01) | AL |
051108289 | BLUE CROSS (01) | AL |
051108290 | BLUE CROSS (01) | AL |
07734004 | (05) | MS |
120931 | (05) | AL |
120933 | (05) | AL |
120935 | (05) | AL |
120937 | (05) | AL |