Healthcare Provider Details

I. General information

NPI: 1457645301
Provider Name (Legal Business Name): GIOVANNA C BEAUCHAMP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 12/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

703 VOLKER HALL
BIRMINGHAM AL
35294-0001
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9107
  • Fax:
Mailing address:
  • Phone: 205-975-9925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number36386
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: