Healthcare Provider Details

I. General information

NPI: 1578730735
Provider Name (Legal Business Name): LAURIE MELAMED ELMETS M.A.,CCC/A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 6TH AVE S DIVISION OF OTOLARYNGOLOGY
BIRMINGHAM AL
35233-2110
US

IV. Provider business mailing address

2000 6TH AVE S DIVISION OF OTOLARYNGOLOGY
BIRMINGHAM AL
35233-2110
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-9766
  • Fax: 205-801-7840
Mailing address:
  • Phone: 205-934-9766
  • Fax: 205-801-7840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0849A
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number0849A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: