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Individual

DAVID RANDALL MAXWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 SIVLEY RD SW, HUNTSVILLE, AL 35801-4470
(256) 262-2590
Mailing address
PO BOX 12694, HUNTSVILLE, AL 35815-2694
(770) 317-8076

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-175458
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1-175458
AL

Other

Enumeration date
12/14/2020
Last updated
02/23/2024
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