Deshazo, Mollie Rene
Deshazo, Mollie Rene is an individual health care provider with primary practice located at 619 19Th Street South , Birmingham AL 35233. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Deshazo, Mollie Rene can be contacted via phone (205) 934-6600.Contact Information
Primary practice address
619 19Th Street South
Birmingham AL 35233
Phone: (205) 934-6600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 24415 | Alabama |
Profile Details
| NPI number | 1487603841 |
|---|---|
| LBN Legal business name | Deshazo, Mollie Rene |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2006 |
| Last updated | Oct 20th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487603841 | NPPES |
| Alabama | MEDICAID | 009936801 | |
| Alabama | MEDICAID | 009936802 | |
| Alabama | Other | P00376923 | |
| Alabama | Other | 051534114 | |
| Alabama | Other | 051534115 | |
| Alabama | Other | 051534116 | |
| Alabama | MEDICAID | 009936803 |
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