# VILMA E PESSOA MDPA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558371351
- **Authorized official:** VILMA E. PESSOA (DOCTOR)
- **Authorized official phone:** (334) 262-2092

## Contact information

- **Practice address:** 1710 NORMAN BRIDGE RD, MONTGOMERY, AL 36104-5631
- **Practice address phone:** (334) 262-2092
- **Mailing address:** 1710 NORMAN BRIDGE RD, MONTGOMERY, AL 36104-5631
- **Mailing address phone:** (334) 262-2092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 4362 | AL | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 02/09/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000800080 | — | AL |
| 01 | — | 051010265 | BLUE CROSS \# | AL |