Individual
MICHELLE M MCNAMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
23620
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00123425
MISSISSIPPI MEDICAID
MS
05
—
009980560
—
AL
01
—
010033CG53486
SECTION 1011
AL
01
—
051506140
BLUE CROSS
AL
01
—
051511505
BLUE CROSS
AL
01
—
051534494
BLUE CROSS
AL
01
—
051550444
BLUE CROSS
AL
05
—
051550444
—
AL
Enumeration date
07/06/2006
Last updated
07/12/2011
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