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Individual

EDGAR S UNDERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
PO BOX 55309, BIRMINGHAM, AL 35255-5309

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
00008292
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009938902
AL
01
051536231
BLUE CROSS
AL
01
051536232
BLUE CROSS
AL
01
051536233
BLUE CROSS
AL
05
06479807
MS
Enumeration date
06/15/2005
Last updated
12/23/2011
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