Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 219550 | MA |
Y | 208000000X | Pediatrician | 27640 | AL |
N | 2080A0000X | Adolescent Medicine | 219550 | MA |
NPI | 1134190424 |
---|---|
Provider Name | Nefertiti H Durant |
First Address | Birmingham, AL 35294-0001 |
Second Address | Birmingham, AL 35233-1711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 08/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0035480 | NEIGHBORHOOD HEALTH (01) | MA |
009939731 | (05) | AL |
2104644 | (05) | MA |
468264 | TUFTS (01) | MA |
AA36449 | HARVARD PILGRIM (01) | MA |
I37141 | (02) | MA |
J28871 | BLUE CROSS (01) | MA |