Individual
DOUGLAS JAMES MINNICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
833 PRINCETON AVENUE SW, POB III; SUITE 200A, BIRMINGHAM, AL 35211
(205) 786-2776
(205) 786-6227
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
223522
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
223522
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
28565
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009913902
—
AL
05
—
009913903
—
AL
01
—
051546484
BCBS OF AL
AL
01
—
051546485
BCBS OF AL
AL
01
—
Z08747
VIVA
AL
Enumeration date
11/22/2005
Last updated
12/07/2016
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