MEDICARE: DR. MICHAEL S POWELL MD

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	208000000X	Pediatrics Physician	8909	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	510-12930	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1710031349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL S POWELL MD

Provider Business Mailing Address
First Line	:	2227 DRAKE AVE SW STE 28
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35805-5146
Country	:	US
Telephone Number	:	256-533-6644
Fax Number	:	256-536-8610

Provider Business Practice Location Address
First Line	:	2227 DRAKE AVE SW STE 28
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35805-5146
Country	:	US
Telephone Number	:	256-533-6644
Fax Number	:	256-536-8610

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	08/17/2023

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