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NPI Code Detail

MEDICARE: HARTWIG P JANDER MD

MEDICARE: HARTWIG P JANDER MD
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
1174400000XSpecialist6411AL
22085R0202XDiagnostic Radiology PhysicianMD6411AL
32085R0204XVascular & Interventional Radiology PhysicianMD6411AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00345188OTHERALRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2051535350OTHERALBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346245545
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARTWIG P JANDER MD
Provider Business Mailing Address
First Line : 2055 NORMANDIE DR
Second Line : SUITE 108
City : MONTGOMERY
State : AL
Zip : 36111-2732
Country : US
Telephone Number : 334-269-6337
Fax Number : 334-834-0657
Provider Business Practice Location Address
First Line : 619 19TH ST S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35249-1900
Country : US
Telephone Number : 205-934-4011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 12/05/2016

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