Individual
DR. JOSEPH N M NDOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 S GREENO RD, FAIRHOPE, AL 36532-1905
(251) 929-0500
(251) 929-0501
Mailing address
310 S GREENO RD, FAIRHOPE, AL 36532-1905
(251) 929-0500
(251) 929-0501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21199
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51509057NDO
BLUE CROSS BLUE SHIELD
AL
Enumeration date
11/21/2005
Last updated
09/17/2012
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