Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | L.4314R | AL |
N | 208600000X | Surgeon | L.4314R | AL |
Y | 2086S0120X | Pediatric Surgery | L.4314R | AL |
NPI | 1144604976 |
---|---|
Provider Name | Miss Tal Koppelmann |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233-1711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2015 |
Last Update Date | 11/03/2019 |