Provider Demographics
NPI:1528311271
Name:UNIV. OF ALABAMA BIRMINGHAM HOSPITAL
Entity type:Organization
Organization Name:UNIV. OF ALABAMA BIRMINGHAM HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMIL
Authorized Official - Middle Name:MARCIN
Authorized Official - Last Name:PIETRASIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:205-934-3245
Mailing Address - Street 1:510 20TH STREET, SOUTH (FOT-1164)
Mailing Address - Street 2:UAB, PLASTIC SURGERY
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-3411
Mailing Address - Country:US
Mailing Address - Phone:205-934-3245
Mailing Address - Fax:205-975-6155
Practice Address - Street 1:510 20TH ST. SO (FOT-1164)
Practice Address - Street 2:UAB, PLASTIC SURGERY
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-3411
Practice Address - Country:US
Practice Address - Phone:205-934-3245
Practice Address - Fax:205-975-6155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL3716F282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital