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General NPI Number Information
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NPI Number | 1003901240
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Entity Type | Organization
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Legal Business Name | ALABAMA PEDIATRIC GASTROENTEROLOGY, P.C.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 2151 HIGHLAND AVE S SUITE 225
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City | BIRMINGHAM
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State | AL
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Zip | 35205-4079
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Country | US
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Telephone | 205-933-5744
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Fax | 205-933-6666
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Provider Business Mailing Address
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Address Line | 2151 HIGHLAND AVE S SUITE 225
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City | BIRMINGHAM
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State | AL
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Zip | 35205-4079
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Country | US
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Telephone | 205-933-5744
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Fax | 205-933-6666
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CARY CAVENDAR
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Credential | M.D.
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Telephone | 205-933-5744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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