Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 1-140880 | AL |
NPI | 1114405461 |
---|---|
Provider Name | Mrs. Chanley Alexa Whitcomb |
First Address | Vestavia, AL 35243-5720 |
Second Address | Birmingham, AL 35233-1711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2018 |
Last Update Date | 30/07/2018 |