Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD29418 | AL |
Y | 2080P0216X | Pediatric Rheumatologist | 29418 | AL |
NPI | 1417122870 |
---|---|
Provider Name | Peter Weiser |
First Address | Birmingham, AL 35294-0001 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 14/05/2019 |