Individual
NAMASIVAYAM AMBALAVANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 NHB, 619 SOUTH 19TH STREET, BIRMINGHAM, AL 35249-0001
(205) 996-2244
(205) 996-2254
Mailing address
PO BOX 55823, BIRMINGHAM, AL 35255-5823
(205) 996-2244
(205) 996-2254
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
20362
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00124464
MISSISSIPPI MEDICAID
AL
01
—
4710057
UHC
AL
01
—
47489
HEALTHSPRING
AL
01
—
51098585
BC BS
AL
05
—
9940270
—
AL
01
—
G21455
VIVA
—
Enumeration date
06/16/2006
Last updated
07/08/2007
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