Individual
DR. MARK L. MIDENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
115 QUEENSBURY DR SW, HUNTSVILLE, AL 35802-1501
(256) 880-0222
(256) 880-3404
Mailing address
115 QUEENSBURY DR SW, HUNTSVILLE, AL 35802-1501
(256) 880-0222
(256) 880-3404
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
AL116
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72216
BLUE CROSS PROVIDER #
AL
Enumeration date
09/13/2006
Last updated
09/16/2010
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