Healthcare Provider Details

I. General information

NPI: 1306805825
Provider Name (Legal Business Name): DANIEL MIRELMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 10/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 BROOKWOOD MEDICAL CTR DR SUITE 313 ACC
BIRMINGHAM AL
35209-6808
US

IV. Provider business mailing address

2022 BROOKWOOD MEDICAL CTR DR SUITE 313 ACC
BIRMINGHAM AL
35209-6808
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-2910
  • Fax: 205-879-4649
Mailing address:
  • Phone: 205-877-2910
  • Fax: 205-879-4649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number8570
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number8570
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: