Healthcare Provider Details

I. General information

NPI: 1417484676
Provider Name (Legal Business Name): ERIN NICOLE SHOWALTER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3686 GRANDVIEW PKWY STE 320
BIRMINGHAM AL
35243-3404
US

IV. Provider business mailing address

3686 GRANDVIEW PKWY STE 320
BIRMINGHAM AL
35243-3404
US

V. Phone/Fax

Practice location:
  • Phone: 205-971-5499
  • Fax: 205-971-5438
Mailing address:
  • Phone: 205-971-5499
  • Fax: 205-971-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberDO.2622
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: