1427020171 NPI number — DR. NATALIE JOSEPHINE GIAMMANCO DPM

Table of content: DR. NATALIE JOSEPHINE GIAMMANCO DPM (NPI 1427020171)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427020171 NPI number — DR. NATALIE JOSEPHINE GIAMMANCO DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIAMMANCO
Provider First Name:
NATALIE
Provider Middle Name:
JOSEPHINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

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:
1427020171
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
805 SAINT VINCENTS DR
Provider Second Line Business Mailing Address:
SUITE 420
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35205-1636
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-324-8511
Provider Business Mailing Address Fax Number:
205-314-8551

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1985 AL HIGHWAY 157
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
CULLMAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35058-0692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-739-1912
Provider Business Practice Location Address Fax Number:
205-314-8551
Provider Enumeration Date:
02/06/2006

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: 213EP1101X , with the licence number:  219 , 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: 009999840 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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