Provider Demographics
NPI:1144583436
Name:ECHEMENDIA, NICHOLAS G (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:G
Last Name:ECHEMENDIA
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 1:48 MEDICAL PARK DR E
Mailing Address - Street 2:STE 356
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3406
Mailing Address - Country:US
Mailing Address - Phone:205-702-6602
Mailing Address - Fax:888-206-1336
Practice Address - Street 1:48 MEDICAL PARK DR E
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3400
Practice Address - Country:US
Practice Address - Phone:205-838-3800
Practice Address - Fax:865-305-8894
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL35131207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine