Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 38075 | AL |
NPI | 1003223603 |
---|---|
Provider Name | Riaz Mohammed Karukappadath |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2014 |
Last Update Date | 02/07/2019 |