Provider Demographics
NPI:1285786590
Name:NAMAN, MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:NAMAN
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 1:5675 THREE NOTCH RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-1617
Mailing Address - Country:US
Mailing Address - Phone:251-445-4440
Mailing Address - Fax:251-445-4435
Practice Address - Street 1:5675 THREE NOTCH RD
Practice Address - Street 2:SUITE C
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-1617
Practice Address - Country:US
Practice Address - Phone:251-445-4440
Practice Address - Fax:251-445-4435
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025929208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I25017Medicare UPIN