Provider Demographics
NPI:1144240656
Name:VALDERRAMA, RODRIGO (MD)
Entity Type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:
Last Name:VALDERRAMA
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 1:101 MISSIONARY RDG STE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5203
Mailing Address - Country:US
Mailing Address - Phone:205-971-2450
Mailing Address - Fax:
Practice Address - Street 1:101 MISSIONARY RDG STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5203
Practice Address - Country:US
Practice Address - Phone:205-971-2450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28930207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1030782OtherCIGNA
AL138784Medicaid
ALP01092568OtherMEDICARE RAILROAD
AL11828316OtherCAQH
AL51127445OtherBCBS
AL1030782OtherCIGNA
AL138784Medicaid