Provider Demographics
NPI:1760432983
Name:CARRAWAY INTERNAL MEDICINE ASSOCIATES PC
Entity Type:Organization
Organization Name:CARRAWAY INTERNAL MEDICINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARRAWAY-HANDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-939-4939
Mailing Address - Street 1:1201 11TH AVE S
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-3410
Mailing Address - Country:US
Mailing Address - Phone:205-939-4939
Mailing Address - Fax:205-939-4938
Practice Address - Street 1:1201 11TH AVE S
Practice Address - Street 2:SUITE 305
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-3410
Practice Address - Country:US
Practice Address - Phone:205-939-4939
Practice Address - Fax:205-939-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529905710Medicaid
AL529905710Medicaid