Provider Demographics
NPI:1225178031
Name:WOHLMAN, MARLA H (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLA
Middle Name:H
Last Name:WOHLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 MAIN STREET
Mailing Address - Street 2:PO BOX 589
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054
Mailing Address - Country:US
Mailing Address - Phone:334-285-7808
Mailing Address - Fax:334-285-7810
Practice Address - Street 1:3351 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054
Practice Address - Country:US
Practice Address - Phone:334-285-7808
Practice Address - Fax:334-285-7810
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51048998OtherBLUE CROSS
ALK270OtherMEDICARE PTAN
AL000048998Medicaid
ALB64692Medicare UPIN