Healthcare Provider Details

I. General information

NPI: 1861611196
Provider Name (Legal Business Name): CANDICE C. DYE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

703 VOLKER HL
BIRMINGHAM AL
35294-0001
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3795
  • Fax:
Mailing address:
  • Phone: 205-934-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33562
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: