Provider Demographics
NPI:1265784292
Name:UNIVERSITY OF ALABAMA AT BIRMINGHAM
Entity type:Organization
Organization Name:UNIVERSITY OF ALABAMA AT BIRMINGHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FELLOW
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:OSWALDO
Authorized Official - Last Name:RAMOS GALLARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-934-3245
Mailing Address - Street 1:FOT 1164 1720 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-3411
Mailing Address - Country:US
Mailing Address - Phone:205-934-3245
Mailing Address - Fax:
Practice Address - Street 1:FOT 1164 1720 2 ND AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-3411
Practice Address - Country:US
Practice Address - Phone:205-934-3245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital