Healthcare Provider Details

I. General information

NPI: 1649651217
Provider Name (Legal Business Name): DAVID NERY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PROVIDENCE PARK DR E
MOBILE AL
36695-4616
US

IV. Provider business mailing address

600 PROVIDENCE PARK DR E
MOBILE AL
36695-4616
US

V. Phone/Fax

Practice location:
  • Phone: 251-634-1544
  • Fax: 251-634-0235
Mailing address:
  • Phone: 251-634-1544
  • Fax: 251-634-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number47959
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number47959
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number47959
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: