Healthcare Provider Details

I. General information

NPI: 1710114079
Provider Name (Legal Business Name): ALWIN LAMUEL ALBERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 836 BOX 453
FPO AE
09636-0008
US

IV. Provider business mailing address

PSC 836 BOX 453
FPO AE
09636-0008
US

V. Phone/Fax

Practice location:
  • Phone: 334-383-2744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberA147046
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: