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NPI 1306806591

NPI 1306806591 : VERBENA MARIA SUGG M.D. : BIRMINGHAM, AL

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General NPI Number Information
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    NPI Number           |    1306806591
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    Entity Type          |    Individual 
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    Provider Name        |    VERBENA MARIA SUGG M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/23/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2817 30TH AVE N 
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    City                 |    BIRMINGHAM
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    State                |    AL
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    Zip                  |    35207-4541
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    Country              |    US
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    Telephone            |    205-323-4548
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    Fax                  |    205-521-6851
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Provider Business Mailing Address
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    Address Line         |    2817 30TH AVE N 
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    City                 |    BIRMINGHAM
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    State                |    AL
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    Zip                  |    35207-4541
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    Country              |    US
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    Telephone            |    205-323-4548
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    Fax                  |    205-521-6851
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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        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    00009708
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    License Number State |    AL
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