Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 11375 | AL |
NPI | 1033187034 |
---|---|
Provider Name | Victoria Masear |
First Address | Birmingham, AL 35235 |
Second Address | Birmingham, AL 35235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 22/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000028286 | (05) | AL |
C75433 | (02) |