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Individual

SHIMSHON PORAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
429 E 9TH ST, ANNISTON, AL 36207-4749
(256) 241-2671
(256) 241-2676
Mailing address
429 E 9TH ST, ANNISTON, AL 36207-4749
(256) 241-2671
(256) 241-2676

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18386
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122020
AL
01
511-08886
BCBS OF AL
AL
Enumeration date
09/09/2008
Last updated
04/24/2013
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