Healthcare Provider Details
I. General information
NPI: 1689613473
Provider Name (Legal Business Name): DONNELLY B HOWARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
75 S UNIVERSITY BLVD
MOBILE AL
36608-3271
US
IV. Provider business mailing address
3929 AIRPORT BLVD # 1
MOBILE AL
36609-1987
US
V. Phone/Fax
- Phone: 251-660-5787
- Fax: 251-460-7923
- Phone: 251-470-5842
- Fax: 251-470-5809
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 25493 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 25493 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: