Provider Information for 1972164622
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BEN DEBELL
Sex: Male
NPI: 1972164622
Last Updated: 2019-06-24
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1972164622 | ||||||||||||
| Enumeration Date | 2019-06-24 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 362084 BIRMINGHAM, AL 35236-2084 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 2104 ROCKY RIDGE RD VESTAVIA HILLS, AL 35216-5138 United States Phone: 205-826-7462 | Fax: | ||||||||||||
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