Provider Demographics
NPI:1134190424
Name:DURANT, NEFERTITI H (MD)
Entity type:Individual
Prefix:
First Name:NEFERTITI
Middle Name:H
Last Name:DURANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NEFERTITI
Other - Middle Name:
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:703 VOLKER HL
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0001
Mailing Address - Country:US
Mailing Address - Phone:205-934-3795
Mailing Address - Fax:
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:CHILDREN'S HOSPITAL
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-934-3795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219550208000000X, 2080A0000X
AL27640208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2104644Medicaid
AL009939731Medicaid
MA468264OtherTUFTS
MAAA36449OtherHARVARD PILGRIM
MAJ28871OtherBLUE CROSS
MA0035480OtherNEIGHBORHOOD HEALTH
AL009939731Medicaid
MAAA36449OtherHARVARD PILGRIM