Individual
DR. RICHARD WILSON SHAMBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11910
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51014598
BLUE CROSS PROVIDER NUMBER
AL
05
—
528502230
—
AL
Enumeration date
08/29/2006
Last updated
12/16/2010
Update your record
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