Provider Demographics
NPI:1881286912
Name:EAST ALABAMA MATERNAL FETAL MEDICINE
Entity type:Organization
Organization Name:EAST ALABAMA MATERNAL FETAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:334-528-1310
Mailing Address - Street 1:994 DREW LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4302
Mailing Address - Country:US
Mailing Address - Phone:334-528-5960
Mailing Address - Fax:334-528-5969
Practice Address - Street 1:994 DREW LN
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4302
Practice Address - Country:US
Practice Address - Phone:334-528-5960
Practice Address - Fax:334-528-5969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST ALABAMA MEDICAL DEVELOPMENT ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty