Individual
HAIDEE T. CUSTODIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1601 CENTER STREET, STE 1S, MOBILE, AL 36604-3207
(251) 410-5437
(251) 434-3852
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 410-5437
(251) 434-3852
Taxonomy
Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
30839
AL
390200000X
Student in an Organized Health Care Education/Training Program
TRN12314
FL
Other
Enumeration date
06/03/2008
Last updated
03/06/2017
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