Provider Demographics
NPI:1831350198
Name:MOONEY, DAVID JAMES (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:MOONEY
Suffix:
Gender:M
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:PO BOX 131329
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-6329
Mailing Address - Country:US
Mailing Address - Phone:205-271-8541
Mailing Address - Fax:205-271-8555
Practice Address - Street 1:513 BROOKWOOD BLVD STE 275
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6806
Practice Address - Country:US
Practice Address - Phone:205-502-4700
Practice Address - Fax:205-502-5183
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29814207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK5459OtherRAILROAD MEDICARE
AL1831350198Medicaid
AL1831350195Medicaid