Individual
MATTHEW ALLEN SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3980 COLONNADE PKWY, BIRMINGHAM, AL 35243-2382
(205) 510-5000
(205) 599-9080
Mailing address
3980 COLONNADE PKWY, BIRMINGHAM, AL 35243-2382
(205) 510-5000
(205) 599-9080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
47964
TN
207RC0000X
Cardiovascular Disease Physician
Primary
47964
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529796
—
TN
01
—
6062216
BCBS
TN
05
—
7100213920
—
KY
Enumeration date
04/09/2009
Last updated
02/26/2026
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