1235107046 NPI number — DR. VICTOR FRANCIS SZYMELA DMD, MD

Table of content: NANIK RAM MD (NPI 1093978660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235107046 NPI number — DR. VICTOR FRANCIS SZYMELA DMD, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SZYMELA
Provider First Name:
VICTOR
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD, MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235107046
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
617 HIGHLAND LAKES CV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-6822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-613-5147
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
617 HIGHLAND LAKES CV
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-6822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-613-5147
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  9579 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223S0112X , with the licence number: 3460 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223S0112X , with the licence number: D3460 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207PE0004X , with the licence number: 10355 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223S0112X , with the licence number: 10056 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009944535 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051520008 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 610861200 . This is a "DEPT OF LABOR" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009944515 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009944525 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051523112 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: C141 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: CK8418 . This is a "RR MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051523113 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 351890800 . This is a "DEPT OF LABOR" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: CH5239 . This is a "RR MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051514446 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 529905830 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 529910000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: C144 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 604336100 . This is a "DEPT OF LABOR" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051553268 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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