MEDICARE: MR. NIEL CHRISTIAN RASMUSSEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	00021221	AL

General Provider Information

NPI Number	:	1174560916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NIEL CHRISTIAN RASMUSSEN MD

Provider Business Mailing Address
First Line	:	204 HOLMAN DR
Second Line	:
City	:	HEADLAND
State	:	AL
Zip	:	36345-2307
Country	:	US
Telephone Number	:	334-693-3336
Fax Number	:	334-693-2553

Provider Business Practice Location Address
First Line	:	204 HOLMAN DR
Second Line	:
City	:	HEADLAND
State	:	AL
Zip	:	36345-2307
Country	:	US
Telephone Number	:	334-693-3336
Fax Number	:	334-693-2553

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	07/08/2007

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