Individual
DR. MATHEW MICELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 US HIGHWAY 80 E, DEMOPOLIS, AL 36732-3605
(334) 287-2647
(334) 287-2405
Mailing address
1400 AFFLINK PL, SUITE 100, TUSCALOOSA, AL 35406-2289
(205) 366-9740
(205) 344-9992
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
31266
AL
207RX0202X
Medical Oncology Physician
20438
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02124094
—
MS
Enumeration date
03/23/2006
Last updated
02/27/2015
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