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Individual

DR. VIVIAN CHAMBERS ABOKO-COLE HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4000 BALMORAL DR SW, STE 101, HUNTSVILLE, AL 35801-7431
(256) 533-3525
(256) 533-3242
Mailing address
4000 BALMORAL DR SW, STE 101, HUNTSVILLE, AL 35801-7431
(256) 533-3525
(256) 533-3242

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4144
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14-1840905
FEDERAL TAX ID
AL
01
4144
STATE MEDICAL LICENSE
AL
01
51513859
BLUECROSS/BLUESHIELD
AL
Enumeration date
10/27/2006
Last updated
04/04/2019
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