Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | DO.1588 | AL |
Y | 213ES0000X | Sports Medicine | DO.1588 | AL |
NPI | 1528386406 |
---|---|
Provider Name | Robert Michael Donlan |
First Address | Tuscaloosa, AL 35401 |
Second Address | Tuscaloosa, AL 35401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2010 |
Last Update Date | 16/03/2016 |