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General NPI Number Information
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NPI Number | 1215093224
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Entity Type | Organization
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Legal Business Name | ALABAMA PEDIATRIC PULMONARY
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2660 10TH AVENUE SOUTH STE 701
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1628
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Country | US
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Telephone | 205-776-8789
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Fax | 205-776-8792
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Provider Business Mailing Address
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Address Line | 2660 10TH AVENUE SOUTH STE 701
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1628
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Country | US
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Telephone | 205-776-8789
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Fax | 205-776-8792
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DANA MARIE BRASFIELD
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Credential | MD
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Telephone | 205-776-8789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 4130
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License Number State | AL
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