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Individual

LINCOLN L BERLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
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
10659
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000011138
BLUE CROSS
AL
05
000011138
AL
05
009979460
AL
01
010033CC76032
SECTION 1011
AL
01
0117072
MISSISSIPPI MEDICAID
MS
01
051505963
BLUE CROSS
AL
01
051511814
BLUE CROSS
AL
01
C76032
VIVA
AL
Enumeration date
05/23/2006
Last updated
07/05/2011
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