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NPI Code Detail

MEDICARE: CHRISTINA BAILEY FETTIG M.D.

MEDICARE: CHRISTINA BAILEY FETTIG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician31445AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1511-36794OTHERALBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174841498
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA BAILEY FETTIG M.D.
Provider Business Mailing Address
First Line : 3401 INDEPENDENCE DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35249-1900
Country : US
Telephone Number : 205-870-1273
Fax Number : 205-870-1276
Provider Business Practice Location Address
First Line : 3401 INDEPENDENCE DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35249-1900
Country : US
Telephone Number : 205-870-1273
Fax Number : 205-870-1276
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2010
Last Update Date : 03/30/2017

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