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General NPI Number Information
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NPI Number | 1881776169
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Entity Type | Organization
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Legal Business Name | MOBILE SURGICAL CENTER PA
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 6701 AIRPORT BLVD SUITE B217
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City | MOBILE
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State | AL
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Zip | 36608-6705
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Country | US
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Telephone | 251-633-8881
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Fax | 251-633-0467
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Provider Business Mailing Address
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Address Line | 6701 AIRPORT BLVD SUITE B217
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City | MOBILE
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State | AL
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Zip | 36608-6705
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Country | US
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Telephone | 251-633-8881
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Fax | 251-633-0467
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Authorized Official
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Title or Position | PRES
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Name | DR. ANDREW D BURCH
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Credential | MD
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Telephone | 251-633-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2893
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License Number State | AL
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