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Individual

DR. BRIAN JEFFERY WIATRAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1940 ELMER J. BISSELL ROAD, PEDIATRIC ENT ASSOCIATES, BIRMINGHAM, AL 35243
(205) 638-4949
(205) 638-4983
Mailing address
4931 COLD HARBOR DRIVE, BIRMINGHAM,, AL 35223
(205) 951-5488

Taxonomy

Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
17153
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000045535
AL
01
1010005
UNITED HEALTHCARE
AL
01
1205935012
HOSPITAL NPI
AL
01
2322124
CIGNA HEALTH CARE
AL
01
25457
SOUTHERN HEALTH SYSTEMS
AL
05
529903800
AL
01
63030730626
CHILDRENS HOSPITAL
AL
01
63030730629
CHILDRENS SOUTH
AL
Enumeration date
10/03/2006
Last updated
07/24/2014
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