Provider Demographics
NPI:1700100963
Name:HUBER, DONALD SIMON (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:SIMON
Last Name:HUBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:SIMON
Other - Last Name:HUBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:M,D
Mailing Address - Street 1:507 HOLMES AVE NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4144
Mailing Address - Country:US
Mailing Address - Phone:256-539-0545
Mailing Address - Fax:
Practice Address - Street 1:316 S MAIN ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:AL
Practice Address - Zip Code:36401-3325
Practice Address - Country:US
Practice Address - Phone:251-578-1163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2541207R00000X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology