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
Practitioners 1
-
Kevin David McIntosh, M.D.
National Provider Directory
- Tax ID family
- Advanced OBGYN PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17281 | Medicaid | AL |
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- Advanced OBGYN PC
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All providers in Huntsville, AL · Obstetrics & Gynecology Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.