Basic Information
Provider Information
NPI: 1366454258
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNOW
FirstName: RODNEY
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 BEACON PKWY W
Address2: SUITE 330
City: BIRMINGHAM
State: AL
PostalCode: 352093102
CountryCode: US
TelephoneNumber: 2057155910
FaxNumber: 2057155928
Practice Location
Address1: 833 PRINCETON AVE SW
Address2: POB III; SUITE 210
City: BIRMINGHAM
State: AL
PostalCode: 352111323
CountryCode: US
TelephoneNumber: 2057833740
FaxNumber: 2057833739
Other Information
ProviderEnumerationDate: 08/12/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X5391ALY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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