MEDICARE: DR. CARL MANDEL NECHTMAN III 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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207T00000X	Neurological Surgery Physician	43947	AL

General Provider Information

NPI Number	:	1366839235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL MANDEL NECHTMAN III M.D.

Provider Business Mailing Address
First Line	:	800 SAINT VINCENTS DR STE 700
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1630
Country	:	US
Telephone Number	:	205-933-8981
Fax Number	:	205-930-0746

Provider Business Practice Location Address
First Line	:	800 SAINT VINCENTS DR STE 700
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1630
Country	:	US
Telephone Number	:	205-933-8981
Fax Number	:	205-930-0746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2015
Last Update Date	:	06/08/2022

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