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Organization

BAMA PEDICATRICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BINDU BENNURI MD (PROVIDER)
(205) 333-5900
Entity
Organization

Contact information

Practice address
920 ROSE DRIVE, NORTHPORT, AL 35476
(205) 333-5900
(205) 333-6090
Mailing address
920 ROSE DRIVE, NORTHPORT, AL 35476
(205) 333-5900
(205) 333-6090

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
22564
AL
208000000X
Pediatrics Physician
Primary
22399
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
529921850
AL
Enumeration date
01/10/2007
Last updated
09/23/2009
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