Individual
ONA M FAYE-PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
15559
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000084140
BLUE CROSS
AL
05
—
000084140
—
AL
05
—
00013887
—
MS
05
—
009937511
—
AL
01
—
010033CE84989
SECTION 1011
AL
01
—
051535107
BLUE CROSS
AL
01
—
E84989
VIVA
AL
Enumeration date
06/15/2006
Last updated
09/08/2011
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