Provider Demographics
NPI:1427092246
Name:HAINS, CORALIE S (MD)
Entity type:Individual
Prefix:
First Name:CORALIE
Middle Name:S
Last Name:HAINS
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 1:703 VOLKER HALL
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0001
Mailing Address - Country:US
Mailing Address - Phone:205-934-3795
Mailing Address - Fax:205-975-2499
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-5284
Practice Address - Fax:205-975-7080
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL43342080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000028839Medicaid
AL000083791Medicaid
C76692Medicare UPIN
51083791Medicare ID - Type Unspecified