Healthcare Provider Details

I. General information

NPI: 1780908186
Provider Name (Legal Business Name): ABBY BOWEN MELTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6234 TATTERSALL BLVD
BIRMINGHAM AL
35242-4279
US

IV. Provider business mailing address

6234 TATTERSALL BLVD
BIRMINGHAM AL
35242-4279
US

V. Phone/Fax

Practice location:
  • Phone: 205-453-4195
  • Fax: 205-533-7385
Mailing address:
  • Phone: 205-453-4195
  • Fax: 205-533-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number013914
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number829
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: