Provider Demographics
NPI:1619905593
Name:MCLAIN, AMIE BROWN (MD)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:BROWN
Last Name:MCLAIN
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:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:763-520-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12655208100000X
MN73774208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000017901Medicaid
AL330000005OtherMEDICAID REHAB
AL000075174OtherBLUE CROSS
AL009990950Medicaid
AL250001452OtherRAILROAD MEDICARE
ALR99502OtherVIVA
AL000017901OtherBLUE CROSS
ALE11521OtherVIVA
AL051501372OtherBC FEDERAL EHBP
AL051507900OtherBLUE CROSS
AL680011661OtherRAILROAD MEDICARE
AL330000005OtherMEDICAID REHAB
AL250001452OtherRAILROAD MEDICARE