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Individual

DR. GEROLD NOEL SIBANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
832 PRINCETON AVE SW, BIRMINGHAM, AL 35211-1320
(205) 206-8460
(205) 206-8380
Mailing address
PO BOX 12366, BIRMINGHAM, AL 35202-2366
(205) 780-7101
(205) 206-8338

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00021802
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51212983
BLUE CROSS BLUE SHIELD
AL
01
51514660SIB
BLUE CROSS BLUE SHIELD
AL
05
630506063
AL
Enumeration date
08/25/2006
Last updated
10/01/2018
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