Healthcare Provider Details

I. General information

NPI: 1922315241
Provider Name (Legal Business Name): PULMONARY AND CRITICAL CARE SPECIALISTS OF PRINCETON PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 PRINCETON AVE SW SUITE 199
BIRMINGHAM AL
35211-1333
US

IV. Provider business mailing address

817 PRINCETON AVE SW SUITE 199
BIRMINGHAM AL
35211-1333
US

V. Phone/Fax

Practice location:
  • Phone: 205-785-2557
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL CRAIN
Title or Position: PRESIDENT
Credential: MD
Phone: 205-780-1963