Provider Demographics
NPI:1093855637
Name:METRO PEDIATRICS PC
Entity Type:Organization
Organization Name:METRO PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DERROL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-941-1414
Mailing Address - Street 1:401 VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-3805
Mailing Address - Country:US
Mailing Address - Phone:205-941-1414
Mailing Address - Fax:205-941-1313
Practice Address - Street 1:401 VALLEY AVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3805
Practice Address - Country:US
Practice Address - Phone:205-941-1414
Practice Address - Fax:205-941-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0010039174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC-76631Medicare UPIN