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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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