Healthcare Provider Details
I. General information
NPI: 1649275819
Provider Name (Legal Business Name): ROBERT S NAFTEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 MONTCLAIR RD
BIRMINGHAM AL
35213-1908
US
IV. Provider business mailing address
2000A SOUTHBRIDGE PKWY STE 300
BIRMINGHAM AL
35209-7718
US
V. Phone/Fax
- Phone: 205-592-1000
- Fax:
- Phone: 205-871-4274
- Fax: 205-871-4301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 00006020 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: