Provider Demographics
NPI:1215319058
Name:STUDDARD, CAROLINE HOWARD (MD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:HOWARD
Last Name:STUDDARD
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 1:8000 LIBERTY PKWY STE 114
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7563
Mailing Address - Country:US
Mailing Address - Phone:205-968-5988
Mailing Address - Fax:205-968-5990
Practice Address - Street 1:8000 LIBERTY PKWY STE 114
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35242-7563
Practice Address - Country:US
Practice Address - Phone:205-968-5988
Practice Address - Fax:205-968-5990
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL35628207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine