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General NPI Number Information
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NPI Number | 1811526692
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Entity Type | Individual
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Provider Name | ANDREW PAUL FORTUGNO MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 500 22ND ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-3110
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Country | US
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Telephone | 205-934-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 VIRGINIA WAY STE 300
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City | BRENTWOOD
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State | TN
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Zip | 37027-7542
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Country | US
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Telephone | 615-221-4400
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Fax |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD.43426
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 43426
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License Number State | AL
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