Healthcare Provider Details
I. General information
NPI: 1548242563
Provider Name (Legal Business Name): MICHAEL A DRUMMOND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/16/2005
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
817 PRINCETON AVE SW SUITE 306
BIRMINGHAM AL
35211-1333
US
IV. Provider business mailing address
817 PRINCETON AVE SW SUITE 306
BIRMINGHAM AL
35211-1333
US
V. Phone/Fax
- Phone: 205-783-0160
- Fax: 205-788-6249
- Phone: 205-783-0160
- Fax: 205-788-6249
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 00013686 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: