Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 4130 | AL |
NPI | 1407950132 |
---|---|
Provider Name | Mrs. Dana Brasfield Bussey |
First Address | Birmingham, AL 35205-1628 |
Second Address | Birmingham, AL 35205-1628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51537085 | BCBS (01) | |
80640 | BLUE CROSS (01) | AL |
C76577 | (02) |