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General NPI Number Information
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NPI Number | 1861530776
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Entity Type | Organization
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Legal Business Name | TWICKENHAM PEDIATRICS
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 115 MANNING DR SW SUITE A101
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4315
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Country | US
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Telephone | 256-533-1030
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Fax | 256-533-1043
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Provider Business Mailing Address
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Address Line | 115 MANNING DR SW SUITE A101
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4315
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Country | US
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Telephone | 256-533-1030
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Fax | 256-533-1043
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Authorized Official
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Title or Position | M.D.
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Name | DR. MURIEL A DESIMONE
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Credential | MD
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Telephone | 256-533-1030
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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 |
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License Number State |
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