Individual
DR. MARK S DEGUENTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3485 INDEPENDENCE DR, HOMEWOOD, AL 35209-5603
(205) 930-0920
(205) 445-0115
Mailing address
3485 INDEPENDENCE DR, HOMEWOOD, AL 35209-5603
(205) 930-0920
(205) 445-0115
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
00018730
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000025361
MEDICARE PTAN
AL
05
—
000025361
—
AL
01
—
0366100001
MC NSC
AL
01
—
1910105
UNITED HEALTHCARE
AL
01
—
2308260001
CIGNA
AL
01
—
5375053
AETNA
AL
01
—
D815
MEDICARE GROUP PIN
AL
01
—
E84894
VIVA
AL
Enumeration date
02/10/2006
Last updated
11/24/2014
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