Individual
MIRANDA P FRITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1940 STONEGATE DR STE 130, VESTAVIA HLS, AL 35242
(205) 977-9876
(205) 977-9976
Mailing address
1940 STONEGATE DR STE 130, VESTAVIA HLS, AL 35242-2541
(205) 977-9876
(205) 977-9976
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA.346
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051048148
BCBS OF AL
AL
01
—
051048149
BCBS OF AL
AL
01
—
051048150
BCBS OF AL
AL
05
—
107776
—
AL
01
—
510-00264
BCBS OF AL
AL
01
—
51048148
BCBS OF AL
AL
01
—
51048149
BCBS OF AL
AL
01
—
51048150
BCBS OF AL
AL
01
—
510I970130
MEDICARE
AL
Enumeration date
08/20/2006
Last updated
09/07/2018
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