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General NPI Number Information
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NPI Number | 1255623021
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Entity Type | Organization
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Legal Business Name | DIABETES AND ENDOCRINE WELLNESS CENTER LLC
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 09/06/2011
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Provider Practice Location Address
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Address Line | 1 HOSPITAL DR SW SUITE 300
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6455
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Country | US
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Telephone | 256-881-2700
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Fax | 866-966-9740
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Provider Business Mailing Address
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Address Line | PO BOX 16099
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1662
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Country | US
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Telephone | 256-881-2700
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Fax | 866-966-9740
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Authorized Official
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Title or Position | MD
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Name | MR. DWAIN ERSKIN WOODE
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Credential |
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Telephone | 256-881-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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