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Organization

DCH MEDICAL CENTER CRNA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL G WILSON (DIRECTOR BUSINESS SERVICES)
(205) 343-8500
Entity
Organization

Contact information

Practice address
809 UNIVERSITY BLVD E, TUSCALOOSA, AL 35401-2029
(205) 343-8500
(205) 759-6397
Mailing address
PO BOX 660257, BIRMINGHAM, AL 35266-0257
(205) 979-5882
(205) 979-1248

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
124648
AL
Enumeration date
11/11/2010
Last updated
08/08/2014
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