Provider Demographics
NPI:1396763769
Name:MILLER, WENDY REBECCA WALDROP (MD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:REBECCA WALDROP
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3188 BRADFORD PL
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4602
Mailing Address - Country:US
Mailing Address - Phone:205-215-2529
Mailing Address - Fax:205-971-1703
Practice Address - Street 1:101 MISSIONARY RDG STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5203
Practice Address - Country:US
Practice Address - Phone:205-995-2529
Practice Address - Fax:205-995-2539
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23674207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051597198OtherBLUE CROSS
AL051515998OtherBLUE CROSS
ALP00046016OtherRAILROAD MEDICARE
AL108950Medicaid
AL051553676Medicaid
AL051597198OtherBLUE CROSS