DR. MATHEW MICELI (NPI# 1447210745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447210745 |
| Entity Type | Individual |
| Full Name | DR. MATHEW MICELI |
| Credential | MD |
| Practice Address |
105 Us Highway 80 E Demopolis AL 36732-3605 |
| Mailing Address |
1400 Afflink Pl Suite 100 Tuscaloosa AL 35406-2289 |
| Practice Telephone | 3342872647 |
| Practice Fax Number | 3342872405 |
| Mailing Telephone | 2053669740 |
| Mailing Fax Number | 2053449992 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2015-02-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
31266 | AL | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
20438 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02124094 | 05 |
| Street Address |
105 US HIGHWAY 80 E |
| City | DEMOPOLIS |
| State | AL |
| Zip Code | 36732-3605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134194905 | Alex K Curtis | Family Medicine | 105 Us Highway 80 E, Demopolis, AL 36732-3605 | 2006-02-22 |
| 1124674031 | Laura E Glass | Nurse Practitioner | 105 Us Highway 80 E, Demopolis, AL 36732-3605 | 2019-08-15 |
| 1457822942 | Cassandra Latham | Nurse Practitioner | 105 Us Highway 80 E, Demopolis, AL 36732-3605 | 2018-12-10 |
| 1487011086 | Tombigbee Healthcare Authority | Family Medicine | 105 Us Highway 80 E, Ste 215, Demopolis, AL 36732-3605 | 2016-01-27 |
| 1396037818 | Kaitlyn Bailey | Dietitian, Registered | 105 Us Highway 80 E, Nutrition Department, Demopolis, AL 36732-3605 | 2011-05-03 |
| 1699914770 | Demopolis Pediatrics | Pediatrics | 105 Us Highway 80 E, Suite 205, Demopolis, AL 36732-3605 | 2009-02-12 |
| 1700057916 | Fernando Alegria, Md, LLC | Surgery | 105 Us Highway 80 E, Suite 225, Demopolis, AL 36732-3605 | 2008-03-14 |
| 1700079134 | Alvin Wayne Rowell | Emergency Medicine | 105 Us Highway 80 E, Demopolis, AL 36732-3605 | 2007-08-20 |
| 1447450465 | Ronnie Chu, M. D., P C | Legal Medicine | 105 Us Highway 80 E, Suite 215, Demopolis, AL 36732-3605 | 2007-07-18 |
| 1902933757 | Bryan Whitfield Mem Hosp Amb | Ambulance | 105 Us Highway 80 E, Demopolis, AL 36732-3605 | 2007-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790336196 | Preferred Eye Care LLC | Optometrist | 931 Highway 80 West, Suite A, Demopolis, AL 36732 | 2019-09-26 |
| 1215454517 | Braxton Senior Care | Day Training/Habilitation Specialist | 307 South Cherry Avenue, Demopolis, AL 36732 | 2017-08-28 |
| 1699206060 | Jamie Lynn Tucker | Pharmacist | 1107 Lillian Lane, Demopolis, AL 36732 | 2017-03-27 |
| 1578717021 | Sheila Bouler Pfaffman | Counselor | 409 North Walnut Avenue, Demopolis, AL 36732 | 2008-11-11 |
| 1609072537 | Southeast Cancer Network, Inc | Internal Medicine | 105 Highway 80 E., Demopolis, AL 36732 | 2007-06-26 |
| 1720102387 | Drs. Ketcham and Dismukes | Durable Medical Equipment & Medical Supplies | 202 Hwy 80 E, Demopolis, AL 36732 | 2007-03-19 |
| 1942356472 | Dana Eddins | Speech-Language Pathologist | 1400 Herbert St, Demopolis, AL 36732 | 2007-01-26 |
| 1083785182 | Mary Juanita Shakes | Social Worker | 205 Herbert Street, Demopolis, AL 36732 | 2006-11-11 |
| 1114006848 | Rural Health Medical Program, Inc | Clinic/Center | 1502 Highway 80 East, Unit A, Demopolis, AL 36732 | 2006-11-03 |
| 1518051788 | Judy Cooke Travis | Emergency Medicine | 123 East Capitol Street, Demopolis, AL 36732 | 2006-10-03 |
| Find all providers in zip 36732 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609072537 | Southeast Cancer Network, Inc | Internal Medicine | 105 Highway 80 E., Demopolis, AL 36732 | 2007-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801211958 | Antonio Di Stasi | Internal Medicine | 1802 6th Ave S # Np255, Birmingham, AL 35233-1932 | 2014-02-26 |
| 1417398033 | Rehan Ajmal Sarmad | Internal Medicine | 625 19th Street South Birmingham, Birmingham, AL 35249 | 2013-07-11 |
| 1336409838 | Marshall Medical Center South Medical Oncology Services | Internal Medicine | 2505 U. S. Highway 431, Boaz, AL 35957-9999 | 2012-05-18 |
| 1548550833 | John Richard Nicholson IIi | Internal Medicine | 201 Sivley Rd Sw Ste 200, Huntsville, AL 35801-5177 | 2011-04-08 |
| 1093018681 | Shelby-chilton Hematology and Oncology LLC | Internal Medicine | 644 2nd St Ne Ste 202, Alabaster, AL 35007-8823 | 2010-12-21 |
| 1003122573 | Amitkumar Mehta | Internal Medicine | 1720 2nd Ave S # Np2540t, Birmingham, AL 35294-3528 | 2010-08-23 |
| 1447579644 | Alabama Cancer Care, LLC | Internal Medicine | 171 Town Center Dr Ste 6, Anniston, AL 36205 | 2010-05-27 |
| 1033443775 | Hematology & Oncology Associates of Alabama | Internal Medicine | 339 Walker Chapel Plaza, Suite 109, Fultondale, AL 35068 | 2009-09-29 |
| 1831350198 | David James Mooney | Internal Medicine | 513 Brookwood Blvd Ste 275, Birmingham, AL 35209-6806 | 2008-06-19 |
| 1578755815 | Oncology Specialties, PC | Internal Medicine | 310 8th Ave Se, Decatur, AL 35601 | 2007-08-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.