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Individual

DANIEL M. INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 SIVLEY RD SW, HUNTSVILLE, AL 35801-4421
(256) 265-9889
Mailing address
712 UPPER HURRICANE RD, NEW MARKET, AL 35761-7623
(256) 379-3074

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.27361
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009939752
AL
05
009940214
AL
01
051003734
BCBS
AL
01
051537253
BCBS
AL
05
051557874
AL
05
64095532
KY
01
7779690
AETNA
AL
Enumeration date
02/14/2006
Last updated
12/20/2007
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