Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 503 | AL |
Y | 222Z00000X | Podiatrist | 503 | AL |
NPI | 1013160886 |
---|---|
Provider Name | Mr. Audwin Darrell Harwell |
First Address | Montgomery, AL 36109-3725 |
Second Address | Montgomery, AL 36109-3725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2008 |
Last Update Date | 24/10/2008 |