Individual
BIRAJ BHAKTA BISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 975-4850
Mailing address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 975-4850
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A132850
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2011
Last updated
02/23/2018
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