Individual
MARY ELIZABETH PATRENOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3312 HENRY RD, ANNISTON, AL 36207-6344
(256) 241-2671
(256) 241-2676
Mailing address
3312 HENRY RD, ANNISTON, AL 36207-6344
(256) 241-2671
(256) 241-2676
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
037042
GA
208000000X
Pediatrics Physician
Primary
14173
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000553418C
—
GA
05
—
155563
—
AL
01
—
511-44651
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
02/27/2006
Last updated
07/22/2014
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