Provider Demographics
NPI:1235123167
Name:VENZ-WILLIAMSON, TERESA L (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:L
Last Name:VENZ-WILLIAMSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:VENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:DRAWER 428
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0100
Mailing Address - Country:US
Mailing Address - Phone:800-897-6169
Mailing Address - Fax:800-897-6170
Practice Address - Street 1:1004 1ST ST N
Practice Address - Street 2:SUITE 200
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8766
Practice Address - Country:US
Practice Address - Phone:888-737-9797
Practice Address - Fax:205-664-1879
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14902207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF57514Medicare UPIN