Mark Bruce Nissenbaum M.D.

NPI 1003894502 - Internal Medicine - 207RG0100X

NPI Details
NPI 1003894502
Gender Male
Enumeration Date 01/04/2006
Last Updated 07/09/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
3701 LOOP RD
VA MEDICAL CENTER (679/11)
TUSCALOOSA AL, 35404-5015, US
Phone (205) 554-2000
Fax (205) 554-2034
Business Location
3701 LOOP RD
VA MEDICAL CENTER (679/11)
TUSCALOOSA AL, 35404-5015, US
Phone (205) 554-2000
Fax (205) 554-2034
Toxanomy
Taxonomy Code 207RG0100X
License State New York
License Number 122786
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According to our database, Dr. Mark Bruce Nissenbaum M.D. NPI is 1003894502, taxonomy code is 207RG0100X and license number is 122786, license state is located at New York. Mark Bruce Nissenbaum M.D. physically located at 3701 Loop Rd, Tuscaloosa AL, 35404-5015. NPI Number Mark Bruce Nissenbaum M.D. has the Individual type.

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1003894502 NPI number is provided on an as is basis without warranty of any kind. 1003894502 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Bruce Nissenbaum M.D. are for informational purposes only.