Edith A Aguayo, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Huntsville, AL
NPI 1467546036 · NPPES record last updated Nov 3, 2015
Key facts
- NPI
- 1467546036
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 25842 (AL)
- Practice address
- 610 Airport Rd SW
Suite 210
Huntsville, AL 35802 - Phone
- (256) 882-1785
- Fax
- (256) 882-1770
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050307000207 | AL | Practitioner - Obstetrics/Gynecology | 3173577731 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 25842 | AL | Yes |
Addresses
Primary practice location
610 Airport Rd SW
Suite 210
Huntsville, AL 35802
Mailing address
610 Airport Rd. SW
Suite 210
Huntsville, AL 35802
Phone (256) 882-1785
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009978495 | Medicaid | AL | |
| 051525573 | Other | AL | MEDICARE ID-TYPE UNSPECIF |
| 51525573 | Other | AL | BLUE CROSS BLUE SHIELD |
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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 3, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.