Individual
ANDREAS TIRSO MADDUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3240 EDWARDS LAKE PKWY, 204, BIRMINGHAM, AL 35235-3117
(205) 949-1414
(205) 949-1415
Mailing address
3240 EDWARDS LAKE PKWY, 204, BIRMINGHAM, AL 35235-3117
(205) 702-6604
(205) 949-1415
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
00013482
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051553190
—
AL
01
—
1043321300
GROUP NPI
AL
01
—
1316985062
NPI
AL
Enumeration date
06/03/2006
Last updated
06/24/2020
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