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NPI Code Detail

MEDICARE: ABIGAIL CALAMETTI BRODER M.D.

MEDICARE: ABIGAIL CALAMETTI BRODER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080N0001XNeonatal-Perinatal Medicine PhysicianMD.40933AL
2390200000XStudent in an Organized Health Care Education/Training Program
3208000000XPediatrics PhysicianT-3460MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215478508
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL CALAMETTI BRODER M.D.
Provider Business Mailing Address
First Line : 400 TAYLOR RD
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-3511
Country : US
Telephone Number : 334-277-8330
Fax Number :
Provider Business Practice Location Address
First Line : 400 TAYLOR RD
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-3511
Country : US
Telephone Number : 334-277-8330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2017
Last Update Date : 01/29/2026

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