MEDICARE: DR. DALE E. TRAMMELL JR. 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	207R00000X	Internal Medicine Physician	21450	AL

General Provider Information

NPI Number	:	1871596205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALE E. TRAMMELL JR. M.D.

Provider Business Mailing Address
First Line	:	840 MONTCLAIR RD
Second Line	:	STE 500
City	:	BIRMINGHAM
State	:	AL
Zip	:	35213-1946
Country	:	US
Telephone Number	:	205-595-5504
Fax Number	:	205-595-3427

Provider Business Practice Location Address
First Line	:	840 MONTCLAIR RD
Second Line	:	STE 500
City	:	BIRMINGHAM
State	:	AL
Zip	:	35213-1946
Country	:	US
Telephone Number	:	205-595-5504
Fax Number	:	205-595-3427

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/08/2007

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