Provider Demographics
NPI:1164514386
Name:BERTOLI, LUIGI F (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIGI
Middle Name:F
Last Name:BERTOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR
Mailing Address - Street 2:SUITE G105
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6808
Mailing Address - Country:US
Mailing Address - Phone:205-877-2888
Mailing Address - Fax:205-877-2039
Practice Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE G105
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6808
Practice Address - Country:US
Practice Address - Phone:205-877-2888
Practice Address - Fax:205-877-2039
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL10846207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C73044Medicare UPIN