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1003894502
MARK BRUCE NISSENBAUM
TUSCALOOSA, AL
NPI
1003894502
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RG0100X Internal Medicine, Gastroenterology
(Licence: NY 122786)
Enumeration Date
2006-01-04
Last Update Date
2007-07-09
Business Address
Dr. MARK BRUCE NISSENBAUM M.D.
3701 LOOP RD VA MEDICAL CENTER (679/11)
TUSCALOOSA, AL 35404-5015
Phone number: 205-554-2000
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Mailing Address
Dr. MARK BRUCE NISSENBAUM M.D.
3701 LOOP RD VA MEDICAL CENTER (679/11)
TUSCALOOSA, AL 35404-5015
Phone number: 205-554-2000
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