Provider Demographics
NPI:1003901240
Name:ALABAMA PEDIATRIC GASTROENTEROLOGY, P.C.
Entity Type:Organization
Organization Name:ALABAMA PEDIATRIC GASTROENTEROLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVENDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-933-5744
Mailing Address - Street 1:2151 HIGHLAND AVE S
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4079
Mailing Address - Country:US
Mailing Address - Phone:205-933-5744
Mailing Address - Fax:205-933-6666
Practice Address - Street 1:2151 HIGHLAND AVE S
Practice Address - Street 2:SUITE 225
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-4079
Practice Address - Country:US
Practice Address - Phone:205-933-5744
Practice Address - Fax:205-933-6666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty