Provider Demographics
NPI:1043248339
Name:COLVIN, EDWARD V (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:V
Last Name:COLVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 55823
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5823
Mailing Address - Country:US
Mailing Address - Phone:205-934-4948
Mailing Address - Fax:205-212-3002
Practice Address - Street 1:1700 6TH AVE S
Practice Address - Street 2:STE 9100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1802
Practice Address - Country:US
Practice Address - Phone:205-934-4948
Practice Address - Fax:205-212-3002
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL83882080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL003278752XOtherGEORGIA MEDICAID
11368OtherHEALTHSPRING
AL2510024OtherUHC
AL000012129Medicaid
C71653OtherVIVA
AL00121850OtherMISSISSIPPI MEDICAID
AL510-12129OtherBC BS
C71653Medicare UPIN
AL00121850OtherMISSISSIPPI MEDICAID