Healthcare Provider Details

I. General information

NPI: 1700839255
Provider Name (Legal Business Name): KEVIN SCOTT GIADROSICH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 ROCKY RIDGE RD STE 200
HOOVER AL
35216-5531
US

IV. Provider business mailing address

PO BOX 830230
BIRMINGHAM AL
35283-0230
US

V. Phone/Fax

Practice location:
  • Phone: 205-545-8550
  • Fax: 205-822-0136
Mailing address:
  • Phone: 205-250-6000
  • Fax: 205-250-6848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number25019
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number25019
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: