=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982882270
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAROLINE A REICH MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2008
-----------------------------------------------------
Last Update Date | 02/08/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3634 MONTEVALLO ROAD
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35213
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-871-4274
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2000A SOUTHBRIDGE PARKWAY SUITE 300
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-871-4274
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. CAROLINE A REICH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 205-871-4274
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | 22685
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------