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General NPI Number Information
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NPI Number | 1710334933
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Entity Type | Individual
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Provider Name | ALAN LEVI STICKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | MEDICAL CENTER BLVD DEPARTMENT OF OTOLARYNGOLOGY
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0001
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Country | US
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Telephone | 336-716-3648
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Fax |
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Provider Business Mailing Address
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Address Line | 10310 THE GROVE BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70836-6455
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Country | US
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Telephone | 225-761-5200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 327374
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License Number State | LA
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