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Individual

MRS. DEANN MILLER GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
701 UNIVERSITY BLVD E, SUITE 502, TUSCALOOSA, AL 35401-2086
(205) 349-4131
(205) 759-2569
Mailing address
701 UNIVERSITY BLVD. EAST, SUITE 502, TUSCALOOSA, AL 35401
(205) 349-4131
(205) 759-2569

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
25654
AL
207V00000X
Obstetrics & Gynecology Physician
Primary
25654
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
515-33141
BCBS PROVIDER #
AL
05
528600770
AL
Enumeration date
05/24/2006
Last updated
12/03/2014
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