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General NPI Number Information
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NPI Number | 1093924391
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Entity Type | Individual
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Provider Name | MICHAEL T SOLOMON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 1333 S SAM HOUSTON BLVD
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City | HOUSTON
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State | MO
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Zip | 65483-2046
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Country | US
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Telephone | 417-967-3311
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Fax | 404-666-7390
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Provider Business Mailing Address
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Address Line | 2100 SOUTHBRIDGE PKWY STE 650
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City | BIRMINGHAM
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State | AL
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Zip | 35209-1317
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Country | US
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Telephone | 205-737-0307
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Fax | 404-666-7390
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 34547
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 2024038194
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2024038194
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34547
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 2024038194
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License Number State | MO
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