1811044282 NPI number — MICHAEL JOHN KOHRMAN M.D.

Table of content: ALIVIA TEAGUE (NPI 1083138028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811044282 NPI number — MICHAEL JOHN KOHRMAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOHRMAN
Provider First Name:
MICHAEL
Provider Middle Name:
JOHN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811044282
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7802 DELTA WOODS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAY MINETTE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36507-8167
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-626-0901
Provider Business Mailing Address Fax Number:
251-626-0902

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26211 EQUITY DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
DAPHNE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36526-6189
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-626-0901
Provider Business Practice Location Address Fax Number:
251-626-0902
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2081P2900X , with the licence number:  35.057402 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2081P2900X , with the licence number: MD034146E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2081P2900X , with the licence number: 01052338A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2081P2900X , with the licence number: ME 100056 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , with the licence number: MD R8G18 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2081P2900X , with the licence number: MD.29617 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 43145208700 . This is a "OH WORKERS' COMP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 51049505 . This is a "BLUE CROSS BLUE SHIELD OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 000000033788 . This is a "ANTHEM PROVIDER NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0739106 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 111544 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12519002 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 4412474 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 16250 . This is a "BLUE CROSS BLUE SHIELD OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 060005763 . This is a "RAIL ROAD MEDICARE NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 12519002 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: ME100056 . This is a "FL WORKERS' COMP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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