Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | DO1059 | AL |
NPI | 1033371323 |
---|---|
Provider Name | Nopporn Unnoppet |
First Address | Alabaster, AL 35007 |
Second Address | Alabaster, AL 35007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2008 |
Last Update Date | 14/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107732 | (05) | AL |
510 48272 | BCBS ALABAMA (01) | AL |