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General NPI Number Information
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NPI Number | 1467580415
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Entity Type | Organization
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Legal Business Name | RIVERCHASE OBSTETRICS & GYNECOLOGY
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 130 RIVERCHASE PKWY E
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City | BIRMINGHAM
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State | AL
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Zip | 35244-1811
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Country | US
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Telephone | 205-988-8294
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Fax | 205-403-0376
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Provider Business Mailing Address
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Address Line | 130 RIVERCHASE PKWY E
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City | BIRMINGHAM
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State | AL
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Zip | 35244-1811
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Country | US
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Telephone | 205-988-8294
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Fax | 205-403-0376
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Authorized Official
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Title or Position | OWNER
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Name | DR. GUY E BLAUDEAU
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Credential | MD
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Telephone | 205-988-8294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 7503
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License Number State | AL
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