Healthcare Provider Details
I. General information
NPI: 1013327097
Provider Name (Legal Business Name): CHARLOTTE STEELMAN MACDONELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/30/2014
Last Update Date: 10/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 CENTER ST STE 1N
MOBILE AL
36604-1541
US
IV. Provider business mailing address
1700 CENTER ST CWEB 1, RM 1538
MOBILE AL
36604-3301
US
V. Phone/Fax
- Phone: 251-410-5437
- Fax: 251-434-3802
- Phone: 251-434-3915
- Fax: 251-415-1387
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 34944 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: