Basic Information
| Provider Information | |||||||||
| NPI: | 1538586433 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRELAND | ||||||||
| FirstName: | DAVID | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3779 S BROOKWOOD RD | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN BRK | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352232818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516806850 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2204 LAKESHORE DR STE 140 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352096741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323257125 | ||||||||
| FaxNumber: | 7135122200 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2014 | ||||||||
| LastUpdateDate: | 03/31/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 37961 | AL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.