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General NPI Number Information
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NPI Number | 1477741445
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Entity Type | Organization
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Legal Business Name | MVP PHYSICIANS GROUP, INC.
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 880 MONTCLAIR RD SUITE370
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City | BIRMINGHAM
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State | AL
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Zip | 35213-1972
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Country | US
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Telephone | 205-592-5765
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Fax | 205-592-5707
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Provider Business Mailing Address
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Address Line | 880 MONTCLAIR RD SUITE370
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City | BIRMINGHAM
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State | AL
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Zip | 35213-1972
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Country | US
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Telephone | 205-592-5765
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Fax | 205-592-5707
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MIKE INGRAM
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Credential |
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Telephone | 205-592-5717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease 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 | 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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