Provider Demographics
NPI:1104918309
Name:ZAREMBA, JACK LOUIS (MD)
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:LOUIS
Last Name:ZAREMBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5890 VALLEY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-8668
Mailing Address - Country:US
Mailing Address - Phone:205-655-7600
Mailing Address - Fax:205-655-7446
Practice Address - Street 1:5890 VALLEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-8668
Practice Address - Country:US
Practice Address - Phone:205-655-7600
Practice Address - Fax:205-655-7446
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL9910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000023252Medicaid
C74387Medicare UPIN
AL000023252Medicaid