Provider Demographics
NPI:1326000639
Name:CATENACCI, MICHAEL H (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:CATENACCI
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:PO BOX 11407 DRAWER 624
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0624
Mailing Address - Country:US
Mailing Address - Phone:205-437-6098
Mailing Address - Fax:205-437-5998
Practice Address - Street 1:1806 SIXTH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-0001
Practice Address - Country:US
Practice Address - Phone:205-975-7389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.27015207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1326000639OtherTRICARE SOUTH
AL515-32511OtherBCBS
AL051532511Medicaid
AL104598Medicaid
AL515-92927OtherBCBS
AL515-92927OtherBCBS
AL051532511Medicare PIN
AL515-32511OtherBCBS
AL104598Medicaid