Healthcare Provider Details

I. General information

NPI: 1689892291
Provider Name (Legal Business Name): DAVID LOWELL NIEMEIER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VESTAVIA PKWY STE 130
VESTAVIA AL
35216-3750
US

IV. Provider business mailing address

400 VESTAVIA PKWY STE 130
VESTAVIA AL
35216-3750
US

V. Phone/Fax

Practice location:
  • Phone: 205-823-2373
  • Fax: 205-823-2378
Mailing address:
  • Phone: 205-823-2373
  • Fax: 205-823-2378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4612890
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810001021
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4479
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2116
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: