Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD.29937 | AL |
Y | 2080P0216X | Pediatric Rheumatologist | 29937 | AL |
NPI | 1164683439 |
---|---|
Provider Name | Melissa Lee Mannion |
First Address | Birmingham, AL 35233-1711 |
Second Address | Birmingham, AL 35233-1711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2008 |
Last Update Date | 19/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
128845 | (05) | AL |