Provider Demographics
NPI:1013327097
Name:MACDONELL, CHARLOTTE STEELMAN (MD)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:STEELMAN
Last Name:MACDONELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:KATHERINE
Other - Last Name:STEELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1700 CENTER ST
Mailing Address - Street 2:CWEB 1, RM 1538
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-3301
Mailing Address - Country:US
Mailing Address - Phone:251-434-3915
Mailing Address - Fax:251-415-1387
Practice Address - Street 1:1601 CENTER ST STE 1N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1541
Practice Address - Country:US
Practice Address - Phone:251-410-5437
Practice Address - Fax:251-434-3802
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34944208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics