Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 00005778 | AL |
NPI | 1063415339 |
---|---|
Provider Name | Ralph B Pfeiffer JR. |
First Address | Mobile, AL 36607-3509 |
Second Address | Mobile, AL 36607-3509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 30/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000030016 | (05) | AL |
A26197 | (02) | AL |