Healthcare Provider Details

I. General information

NPI: 1306837588
Provider Name (Legal Business Name): CYNTHIA K MCCALEB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA K GORE

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4117 KENNESAW DR
BIRMINGHAM AL
35213-3225
US

IV. Provider business mailing address

4117 KENNESAW DR
BIRMINGHAM AL
35213-3225
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-2971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberAL04567
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: