Provider Demographics
NPI:1821051053
Name:MEYERS, MARIA GOULAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:GOULAS
Last Name:MEYERS
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 1:500 CAHABA PARK CIR
Mailing Address - Street 2:STE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-8136
Mailing Address - Country:US
Mailing Address - Phone:205-848-2273
Mailing Address - Fax:205-848-2275
Practice Address - Street 1:1700 AVENUE E
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35218-1543
Practice Address - Country:US
Practice Address - Phone:205-788-3321
Practice Address - Fax:205-241-5260
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00020887208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051034810OtherBLUE SHIELD
AL051034815OtherBLUE SHIELD
AL051034809OtherBLUE HIELD
AL303739349Medicaid
AL051034811OtherBLUE SHIELD
AL051034814OtherBLUE SHIELD
ALG56242Medicare UPIN