Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 00024775 | AL |
NPI | 1013977222 |
---|---|
Provider Name | Martin Rodriguez |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35249-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 21/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00453705 | (05) | MS |
051001527 | BCBS (01) | AL |
051556574 | (05) | AL |
102I204284 | MEDICARE (01) | |
110405 | (05) | AL |
110406 | (05) | AL |
110421 | (05) | AL |
110423 | (05) | AL |
121942 | (05) | AL |
51598423 | BLUE CROSS & BLUE SHIELD (01) | AL |
51598424 | BLUE CROSS & BLUE SHIELD (01) | AL |
51598425 | BLUE CROSS & BLUE SHIELD (01) | AL |
51598426 | BLUE CROSS & BLUE SHIELD (01) | AL |
51598429 | BLUE CROSS & BLUE SHIELD (01) | AL |
636005396005 | HUMANA GOLD CHOICE MEDICARE (01) | |
I39674 | (02) | AL |
P00821369 | RAILROAD MEDICARE (01) |