Individual
CHARLES MICHAEL MEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
502 MONTGOMERY HWY, STE 101, VESTAVIA HILLS, AL 35216-1863
(205) 823-0882
Mailing address
502 MONTGOMERY HWY, STE 101, BIRMINGHAM, AL 35216-1862
(205) 823-0882
(205) 823-0872
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
00017189
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051531044
MEDICARE - GARDENDALE PHYSICIAN ASSOC.
AL
01
—
051531585
MEDICARE - NORTH JEFFERSON IMAGING, LLC
AL
01
—
051540087
MEDICARE - HORIZON IMAGING, PC
AL
05
—
051555108
—
AL
01
—
51524439
BCBS AL
AL
01
—
P00189169
RAILROAD MEDICARE
—
Enumeration date
06/30/2005
Last updated
11/15/2016
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