Healthcare Provider Details

I. General information

NPI: 1740422559
Provider Name (Legal Business Name): NATASHA C OWENDOFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATASHA C HERBOLD MD

II. Dates (important events)

Enumeration Date: 03/26/2009
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 E SOUTH BLVD
MONTGOMERY AL
36116-2001
US

IV. Provider business mailing address

336 SEQUOIA DR
MONTGOMERY AL
36113-1210
US

V. Phone/Fax

Practice location:
  • Phone: 334-747-2273
  • Fax:
Mailing address:
  • Phone: 321-508-8529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101281649
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number54294
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: