Provider Demographics
NPI:1477511467
Name:GASTROENTEROLOGY SPECIALISTS OF BIRMINGHAM,P.C.
Entity Type:Organization
Organization Name:GASTROENTEROLOGY SPECIALISTS OF BIRMINGHAM,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-854-8404
Mailing Address - Street 1:100 PILOT MEDICAL DR
Mailing Address - Street 2:STE 225
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3467
Mailing Address - Country:US
Mailing Address - Phone:205-854-8404
Mailing Address - Fax:205-854-4302
Practice Address - Street 1:100 PILOT MEDICAL DR
Practice Address - Street 2:STE 225
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3467
Practice Address - Country:US
Practice Address - Phone:205-854-8404
Practice Address - Fax:205-854-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529302210Medicaid
AL1477511467OtherGASTROENTEROLOGY SPECIALISTS OF BIRMINGHAM, P.C.
AL051556090Medicare PIN
AL1477511467OtherGASTROENTEROLOGY SPECIALISTS OF BIRMINGHAM, P.C.
AL529302210Medicaid