Provider Demographics
NPI:1316945306
Name:SHAIN, ALAN ROY (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:ROY
Last Name:SHAIN
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 1:101 MEMORIAL HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608
Mailing Address - Country:US
Mailing Address - Phone:251-414-5900
Mailing Address - Fax:251-281-1162
Practice Address - Street 1:101 MEMORIAL HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1786
Practice Address - Country:US
Practice Address - Phone:251-414-5900
Practice Address - Fax:251-281-1162
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00010442207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051009451OtherBCBS
AL000009451Medicaid
AL0410447OtherUNITED HEALTHCARE
AL000009451Medicare ID - Type Unspecified
ALC74065Medicare UPIN