Individual
DR. DARRYL DWAYNE PRIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-2008
(205) 934-4011
(205) 297-9411
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
00025739
AL
207R00000X
Internal Medicine Physician
2006-00624
NC
207RC0000X
Cardiovascular Disease Physician
25739
AL
207RI0011X
Interventional Cardiology Physician
Primary
25739
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009997315
—
AL
01
—
14408
BLUECROSSBLUESHIELD
NC
05
—
5905885
—
NC
Enumeration date
04/17/2006
Last updated
04/04/2022
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