Provider Demographics
NPI:1023063559
Name:BEARDEN, DONNA (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:BEARDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:619 19TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14106207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051025165OtherBLUE CROSS
AL110100915OtherRAILROAD MEDICARE
AL051543921OtherBLUE CROSS BLUE SHIELD OF
AL009912052OtherALABAMA MEDICAID
AL051543919OtherBLUE CROSS BLUE SHIELD OF
AL110035846OtherRAILROAD MEDICARE
AL009912053OtherALABAMA MEDICAID
AL009912051OtherALABAMA MEDICAID
AL051538337OtherBC BS MEDICAID
AL000025165Medicaid
AL051543916OtherBLUE CROSS BLUE SHIELD OF
AL051543918OtherBLUE CROSS BLUE SHIELD
AL051543916OtherBLUE CROSS BLUE SHIELD OF