Provider Demographics
NPI:1174790869
Name:PULMONARY MEDICINE ASSOCIATES
Entity type:Organization
Organization Name:PULMONARY MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-620-0359
Mailing Address - Street 1:1022 1ST STREET NORTH
Mailing Address - Street 2:SUITE 501
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007
Mailing Address - Country:US
Mailing Address - Phone:205-620-0359
Mailing Address - Fax:205-620-9686
Practice Address - Street 1:1022 1ST ST N STE 501
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8718
Practice Address - Country:US
Practice Address - Phone:205-620-0359
Practice Address - Fax:205-620-9686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529700450Medicaid
AL27901Medicare PIN
ALC75968Medicare UPIN
ALE38593Medicare UPIN
AL34307Medicare PIN
AL051551754Medicare PIN
AL35508Medicare UPIN
F25824Medicare UPIN
ALC75960Medicare UPIN