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Individual

DR. CARMELO CABALU MENDIOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2202 JORDAN ROAD SW, SUITE 500, FORT PAYNE, AL 35968-3688
(256) 844-2825
(256) 844-2834
Mailing address
2202 JORDAN ROAD SW, SUITE 500, FORT PAYNE, AL 35968-3688
(256) 844-2825
(256) 844-2834

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00017265
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051534925
AL
05
051557680
AL
01
510-03718
BCBS
AL
01
515-34925
BCBS
AL
05
541385603
AL
Enumeration date
05/23/2006
Last updated
01/27/2009
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