Organization
IMPLANTABLE SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARION SOVIC MD (PRESIDENT)
(205) 901-8658
Entity
Organization
Contact information
Practice address
605 QUEENS GATE, BIRMINGHAM, AL 35242-7221
(205) 901-8658
(205) 682-6057
Mailing address
605 QUEENS GATE, BIRMINGHAM, AL 35242-7221
(205) 901-8658
(205) 682-6057
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19417
AL
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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