Individual
RAVEN ALISE OMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
48 MEDICAL PARK DR E STE 458, BIRMINGHAM, AL 35235-3473
(205) 838-1811
Mailing address
7637 WIND GAP LN, PINSON, AL 35126-4001
(205) 901-8255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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