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Individual
ALAN LOUIS DESMOND
Active
Individual
ALAN LOUIS DESMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUD CCC-A
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
2201000219
VA
231H00000X
Audiologist
447
WV
231H00000X
Audiologist
Primary
A0074
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
640000237
RR MEDICARE PALMETTO GBA
—
05
—
9450513
—
VA
05
—
9460000000
—
WV
01
—
DE0534282
PALMETTO GBA MEDICARE PTAN NUMBER PCTN OFFICE
—
01
—
DE0534283
PALMETTO GBA MEDICARE PTAN NUMBER BLFD OFFICE
—
Enumeration date
03/14/2006
Last updated
05/23/2013
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