Advanced OBGYN PC

Organization Active NPI Obstetrics & Gynecology Physician · Huntsville, AL

NPI 1194128330 · NPPES record last updated Nov 6, 2014

Key facts

NPI
1194128330
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
22430 (AL)
Legal business name
ADVANCED OBGYN PC
Practice address
250 Chateau Dr SW
Ste 100
Huntsville, AL 35801-6436
Phone
(256) 881-9997
Fax
(256) 880-3838
NPI assigned
Oct 2, 2014
Organization subpart
No

Authorized official

Name
Michael M Conrad, M.D.
Title
Owner
Phone
(256) 881-9997

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Advanced OBGYN PC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207V00000X 22430 AL Yes

Addresses

Primary practice location

250 Chateau Dr SW
Ste 100
Huntsville, AL 35801-6436

Mailing address

250 Chateau Dr SW
Ste 100
Huntsville, AL 35801-6436
Phone (256) 881-9997

Other identifiers

IdentifierTypeStateIssuer
17281MedicaidAL

Other providers in Huntsville, AL

All providers in Huntsville, AL · Obstetrics & Gynecology Physician in Alabama

Sources for this page

Verify at the official NPI Registry.