SELLERS BOUDREAU (NPI# 1740816677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740816677 |
| Entity Type | Individual |
| Full Name | SELLERS BOUDREAU |
| Practice Address |
1212 Wales Ave Birmingham AL 35213-1414 |
| Practice Telephone | 2513677868 |
| Mailing Telephone | 2513677868 |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1212 WALES AVE |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35213-1414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649771957 | Charles Derrick Franklin | Optometrist | 3928 Montclair Rd Ste 100, Mountain Brk, AL 35213 | 2018-02-22 |
| 1508386541 | Walker Recovery Center | Clinic/Center | 2195 North Airport Road, Jasper, AL 35213 | 2017-06-21 |
| 1730579707 | Jerome Gaeton Ippolito | Internal Medicine | 4412 Fredricksburg Drive, Birmingham, AL 35213 | 2015-01-29 |
| 1255686523 | John Cocoris | Pediatrics | 4334 Kennesaw Drive, Birmingham, AL 35213 | 2012-07-23 |
| 1720350424 | William Nathan Viar Jr. | Surgery | 3824 Forest Glen Dr., Birmingham, AL 35213 | 2012-01-27 |
| 1225306129 | Thomas Wakefield Mears | Surgery | 2324 Brookshire Place, Birmingham, AL 35213 | 2011-12-06 |
| 1295980589 | Joseph Michael Wright | Nurse Anesthetist, Certified Registered | 117 Lorena Ln, Birmingham, AL 35213 | 2008-12-01 |
| 1174772529 | Ernest Cubbage Wood | Pediatrics | 4200 Wilderness Rd, Birmingham, AL 35213 | 2008-09-10 |
| 1851549976 | Kennedy Rhyne Walker | Optometrist | 4226 Mountaindale Road, Birmingham, AL 35213 | 2008-09-03 |
| 1982882270 | Caroline A Reich Md PC | Radiology | 3634 Montevallo Road, Birmingham, AL 35213 | 2008-02-08 |
| Find all providers in zip 35213 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734512 | Namrata Pradeep Landge | Student in an Organized Health Care Education/Training Program | 1919 7th Ave S # 304, Birmingham, AL 35233-2005 | 2020-06-10 |
| 1558985606 | Lauren Miele | Student in an Organized Health Care Education/Training Program | 1701 1st Ave S Apt 655, Birmingham, AL 35233-1864 | 2020-06-04 |
| 1982226031 | James Edward Bryant Jr. | Student in an Organized Health Care Education/Training Program | 1720 2nd Ave S # Cpmc272, Birmingham, AL 35294-0004 | 2020-05-12 |
| 1215558929 | Wangsoo Lee | Student in an Organized Health Care Education/Training Program | 1720 2nd Ave S # 412, Birmingham, AL 35294-1732 | 2020-05-04 |
| 1477173318 | Jeffrey D. Cooney | Student in an Organized Health Care Education/Training Program | 833 Princeton Avenue Sw, Professional Office Bldg 3, Suite 200-e, Birmingham, AL 35211 | 2020-04-21 |
| 1144840224 | Mark Thomas Dean | Student in an Organized Health Care Education/Training Program | S: 625 19th Street South Birmingham Al 35249, Birmingham, AL 35249-0001 | 2020-04-20 |
| 1831726561 | Aniela Sosnowski | Student in an Organized Health Care Education/Training Program | 1720 S Eton St, Birmingham, MI 48009-7249 | 2020-03-24 |
| 1023645702 | Kyle Glisson | Student in an Organized Health Care Education/Training Program | 2000 2nd Ave S Apt 518, Birmingham, AL 35233-2087 | 2020-03-24 |
| 1205462322 | Jeremie Matthew Peabody Lever | Student in an Organized Health Care Education/Training Program | 1825 University Blvd Shel 121, Birmingham, AL 35294-2182 | 2020-03-20 |
| 1497381925 | Jeffrey Robert Singer | Student in an Organized Health Care Education/Training Program | 3842 11th Ave S, Birmingham, AL 35222-4209 | 2020-03-16 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35213 |
Please comment or provide details below to improve the information on SELLERS BOUDREAU.
| 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.