Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 06903 | AL |
NPI | 1043221401 |
---|---|
Provider Name | Winford E. Bearden |
First Address | Birmingham, AL 35202-2366 |
Second Address | Birmingham, AL 35211-1320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 17/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000317 | (05) | AL |
C74626 | (02) | AL |