Healthcare Provider Details

I. General information

NPI: 1548258882
Provider Name (Legal Business Name): NATHAN JOEL GINSBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEMORIAL HOSPITAL DR STE 1E
MOBILE AL
36608-1183
US

IV. Provider business mailing address

PO BOX 7687
MOBILE AL
36670-0687
US

V. Phone/Fax

Practice location:
  • Phone: 251-316-3868
  • Fax: 251-316-3583
Mailing address:
  • Phone: 251-316-3868
  • Fax: 251-316-3868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number7779
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: