Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | MD200817 | LA |
Y | 207K00000X | Allergist & Immunologist | MD30044 | AL |
N | 2080P0201X | Pediatric Allergist | MD.200817 | LA |
NPI | 1982886826 |
---|---|
Provider Name | Maxcie Marie Sikora |
First Address | Homewood, AL 35209-6802 |
Second Address | Homewood, AL 35209-6802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2007 |
Last Update Date | 15/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08836528 | (05) | MS |
1079952 | (05) | LA |