MEDICARE: DR. MARION SOVIC 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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	19417	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588640536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARION SOVIC MD

Provider Business Mailing Address
First Line	:	2270 VALLEYDALE RD STE 200
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-2101
Country	:	US
Telephone Number	:	205-682-6056
Fax Number	:	205-682-6057

Provider Business Practice Location Address
First Line	:	513 BROOKWOOD BLVD STE 101
Second Line	:
City	:	HOMEWOOD
State	:	AL
Zip	:	35209-6878
Country	:	US
Telephone Number	:	205-682-6056
Fax Number	:	205-682-6057

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	04/10/2024

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