Provider Demographics
NPI:1790238202
Name:TRAORE, ROBERT ALPHA
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALPHA
Last Name:TRAORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 WESTWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-5254
Mailing Address - Country:US
Mailing Address - Phone:205-396-7981
Mailing Address - Fax:205-424-1450
Practice Address - Street 1:730 MEMORIAL DR
Practice Address - Street 2:SUITE 108
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-6058
Practice Address - Country:US
Practice Address - Phone:205-424-1450
Practice Address - Fax:205-424-1450
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15-506246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant