Provider Demographics
NPI:1639150303
Name:LAW, ELIZABETH M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:LAW
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 1:3729 MARY TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3261
Mailing Address - Country:US
Mailing Address - Phone:205-856-4440
Mailing Address - Fax:205-856-4445
Practice Address - Street 1:3729 MARY TAYLOR RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3261
Practice Address - Country:US
Practice Address - Phone:205-856-4440
Practice Address - Fax:205-856-4445
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24207208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000101659Medicaid
AL000101659Medicaid