Healthcare Provider Details

I. General information

NPI: 1184121048
Provider Name (Legal Business Name): VICTORIA MCNEAL COWAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 22ND ST S
BIRMINGHAM AL
35233-3110
US

IV. Provider business mailing address

500 22ND ST S
BIRMINGHAM AL
35233-3110
US

V. Phone/Fax

Practice location:
  • Phone: 205-801-7474
  • Fax: 205-801-7945
Mailing address:
  • Phone: 52-801-7474
  • Fax: 205-801-7945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDO.2150
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO.2150
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: