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General NPI Number Information
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NPI Number | 1790023810
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Entity Type | Organization
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Legal Business Name | BROOKWOOD MATERNAL FETAL MEDICINE
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 2006 BROOKWOOD MEDICAL CTR DR SUITE 604; WMP
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6899
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Country | US
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Telephone | 205-877-5113
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Fax | 205-877-5130
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Provider Business Mailing Address
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Address Line | 2006 BROOKWOOD MEDICAL CTR DR SUITE 604; WMP
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6899
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Country | US
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Telephone | 205-877-5113
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Fax | 205-877-5130
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Authorized Official
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Title or Position | CRNP
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Name | MS. GINGER COLE
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Credential | CRNP
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Telephone | 205-877-5113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1-123626
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License Number State | AL
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