Provider Demographics
NPI:1962421263
Name:FALKENBERG, ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:FALKENBERG
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 1:1 HOSPITAL DR SW STE 100
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3495
Mailing Address - Country:US
Mailing Address - Phone:256-319-5400
Mailing Address - Fax:256-327-5977
Practice Address - Street 1:1 HOSPITAL DR SW STE 100
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3495
Practice Address - Country:US
Practice Address - Phone:256-319-5400
Practice Address - Fax:256-327-5977
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00024420174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009931886Medicaid
AL510I920014OtherMEDICARE NUMBER
ALP00267504OtherRR MEDICARE NUMBER
AL009935838Medicaid
AL051540107OtherBLUE CROSS BLUE SHIELD AL
AL529500990Medicaid
AL009938471Medicaid
AL051556180OtherMEDICARE NUMBER
AL102512Medicaid
AL51001810OtherBLUE CROSS BLUE SHIELD AL
AL51533701OtherBLUE CROSS BLUE SHIELD AL
AL51542437OtherBLUE CROSS BLUE SHIELD AL
AL009938471Medicaid
AL009931886Medicaid