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General NPI Number Information
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NPI Number | 1184228348
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Entity Type | Individual
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Provider Name | CHARLES ALAN RILEY MD
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Gender | Male
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Dates
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Enumeration Date | 11/27/2020
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Last Update Date | 02/22/2025
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Provider Practice Location Address
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Address Line | 1802 6TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1932
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Country | US
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Telephone | 205-934-3411
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Fax |
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Provider Business Mailing Address
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Address Line | 2430 HUNTINGTON GLEN DR
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City | BIRMINGHAM
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State | AL
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Zip | 35226-1997
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Country | US
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Telephone |
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS53324
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD.49748
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License Number State | AL
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