Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD.23567 | AL |
N | 208000000X | Pediatrician | MD.23567 | AL |
Y | 2080P0204X | Pediatric Emergency Doctor | MD.23567 | AL |
NPI | 1245227495 |
---|---|
Provider Name | Teresa J Coco |
First Address | Birmingham, AL 35294-0001 |
Second Address | Birmingham, AL 35233-1711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 02/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009980150 | (05) | AL |
101832 | (05) | AL |
1245227495 | TRICARE SOUTH (01) | AL |
515-06518 | BCBS (01) | AL |
515-07925 | BCBS (01) | AL |
7419720 | AETNA (01) | AL |
I04514 | (02) | AL |