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NPI Code Detail

MEDICARE: MICHAEL L INGRAM MD

MEDICARE: MICHAEL L INGRAM 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
12085R0001XRadiation Oncology Physician21828AL

General Provider Information

NPI Number : 1679527949
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL L INGRAM MD
Provider Business Mailing Address
First Line : 4143 CARMICHAEL RD
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-2803
Country : US
Telephone Number : 334-395-2200
Fax Number : 334-395-2290
Provider Business Practice Location Address
First Line : 4143 CARMICHAEL RD
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-2803
Country : US
Telephone Number : 334-395-2200
Fax Number : 334-395-2290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 12/22/2021

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Directions to “ MICHAEL L INGRAM MD” Practice Location

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