MEDICARE: MICHAEL A REMILLARD 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
1	207Q00000X	Family Medicine Physician	21972	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255444089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL A REMILLARD M.D.

Provider Business Mailing Address
First Line	:	200 BEACON PKWY W
Second Line	:	SUITE 330
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-3102
Country	:	US
Telephone Number	:	205-715-5910
Fax Number	:	205-715-5928

Provider Business Practice Location Address
First Line	:	270 VILLAGE PKWY
Second Line	:
City	:	HELENA
State	:	AL
Zip	:	35080-4040
Country	:	US
Telephone Number	:	205-664-9430
Fax Number	:	205-664-1846

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	10/06/2010

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