Provider Demographics
NPI:1841220589
Name:NORTHINGTON, MARIAN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:ELIZABETH
Last Name:NORTHINGTON
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 1:619 19TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24294207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009933597Medicaid
AL051522131OtherBLUE CROSS
AL051531674OtherBLUE CROSS
AL051531673OtherBLUE CROSS
AL009933596Medicaid
AL009933598Medicaid
AL009935684Medicaid
AL051522132OtherBLUE CROSS
AL009933599Medicaid
ALI05787OtherVIVA
AL009933597Medicaid
ALP00283662Medicare PIN