Provider Demographics
NPI:1558453050
Name:PREJEAN, CHARLOTTE MARGOT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:MARGOT
Last Name:PREJEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4730 BELL HILL RD
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-6947
Mailing Address - Country:US
Mailing Address - Phone:205-426-3010
Mailing Address - Fax:205-481-9034
Practice Address - Street 1:4730 BELL HILL RD
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-6947
Practice Address - Country:US
Practice Address - Phone:205-426-3010
Practice Address - Fax:205-481-9034
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24138208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
48700OtherHEALTHSPRINGS OF ALABAMA
AL173895Medicaid
AL511-62692OtherBLUE CROSS
AL009962720Medicaid
12-00156OtherUNITED HEALTHCARE
AL515-03594OtherBLUE CROSS BLUE SHIELD
48700OtherHEALTHSPRINGS OF ALABAMA