Individual
PRADEEP G BHAMBHVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55309, BIRMINGHAM, AL 35255-5309
(205) 731-9701
(205) 297-9411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C51705
CA
207U00000X
Nuclear Medicine Physician
C51705
CA
2085R0202X
Diagnostic Radiology Physician
Primary
28377
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009911796
—
AL
05
—
009911797
—
AL
05
—
009911798
—
AL
01
—
051543570
BCBS
AL
01
—
051543573
BCBS
AL
01
—
051543575
BCBS
AL
05
—
09457344
—
MS
01
—
G71504
VIVA
—
01
—
P00653192
RAILROAD MEDICARE
—
Enumeration date
10/10/2006
Last updated
06/28/2023
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