Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 17874 | AL |
N | 207ND0101X | MOHS-Micrographic Surgeon | 17874 | AL |
NPI | 1255387585 |
---|---|
Provider Name | Matthew Karl Abele |
First Address | Birmingham, AL 35205-1200 |
Second Address | Birmingham, AL 35205-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 13/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51516471ABE | BC/BS JASPER (01) | AL |
51516475ABE | BC/BS 1528 CARRAWAY-BHM (01) | AL |
51516547ABE | BC/BS MAIN OFFICE/BHM (01) | AL |
51516548ABE | BC/BS WINFIELD (01) | AL |
F33059 | (02) |