Provider Demographics
NPI:1134115520
Name:WERDEHOFF, STEVEN G (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:WERDEHOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:DRAWER 0314
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0314
Mailing Address - Country:US
Mailing Address - Phone:405-751-4664
Mailing Address - Fax:405-749-4561
Practice Address - Street 1:101 SIVLEY RD SW
Practice Address - Street 2:EM DEPT
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4421
Practice Address - Country:US
Practice Address - Phone:256-265-9905
Practice Address - Fax:256-265-9910
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026065207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051523711Medicaid
TN415138OtherBCBS
AL009935886Medicaid
AL051523711OtherBCBS
AL051524968OtherBCBS PROVIDER NUMBER
AL051524968Medicaid
AL7626581OtherAETNA
AL051524968Medicaid
AL051524968Medicare PIN
ALP00185946Medicare PIN
AL051523711Medicare PIN