Provider Demographics
NPI:1720730468
Name:ENGLERT, VICTOR ADAM (PA-C PENDING)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:ADAM
Last Name:ENGLERT
Suffix:
Gender:M
Credentials:PA-C PENDING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 19TH ST S APT 302
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1934
Mailing Address - Country:US
Mailing Address - Phone:256-975-6697
Mailing Address - Fax:
Practice Address - Street 1:1 INDEPENDENCE PLZ STE 600
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-2659
Practice Address - Country:US
Practice Address - Phone:205-709-1337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant