Healthcare Provider Details

I. General information

NPI: 1902902398
Provider Name (Legal Business Name): CAHABA VALLEY SURGICAL GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 08/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 2ND ST NE SUITE 206
ALABASTER AL
35007-8823
US

IV. Provider business mailing address

644 2ND ST NE SUITE 206
ALABASTER AL
35007-8823
US

V. Phone/Fax

Practice location:
  • Phone: 205-620-9065
  • Fax: 205-620-9051
Mailing address:
  • Phone: 205-620-9065
  • Fax: 205-620-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: REX A SHERER
Title or Position: PARTNER/OWNER
Credential: MD
Phone: 205-620-9065