Provider Demographics
NPI:1992700199
Name:REICH, CAROLINE A (MD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:A
Last Name:REICH
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 1:2000A SOUTHBRIDGE PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7718
Mailing Address - Country:US
Mailing Address - Phone:205-871-4274
Mailing Address - Fax:205-871-4301
Practice Address - Street 1:3634 MONTEVALLO RD S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-4206
Practice Address - Country:US
Practice Address - Phone:205-567-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22685174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-09172OtherBLUE CROSS
AL511-19337OtherBLUE CROSS
AL122437Medicaid
ALP00909960OtherRRMC
AL511-09173OtherBLUE CROSS
AL122436Medicaid
AL122514Medicaid
AL511-19336OtherBLUE CROSS
AL122516Medicaid
AL511-09174OtherBLUE CROSS
GAP00261255OtherRAILROAD MEDICARE
AL116919Medicaid
AL511-02635OtherBLUE CROSS
AL511-09171OtherBLUE CROSS
AL511-60194OtherBLUE CROSS
AL122437Medicaid
AL511-09171OtherBLUE CROSS
AL122516Medicaid