Mortellaro, Vincent Edward
Mortellaro, Vincent Edward is an individual health care provider with primary practice located at 1600 7Th Ave S , Birmingham AL 35233-1711. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is his primary health care specialty. Mortellaro, Vincent Edward can be contacted via phone (205) 939-9100.Contact Information
Primary practice address
1600 7Th Ave S
Birmingham AL 35233-1711
Phone: (205) 939-9100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | TRN8848 | Florida |
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | 30918 | Alabama |
Profile Details
| NPI number | 1972671287 |
|---|---|
| LBN Legal business name | Mortellaro, Vincent Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Oct 11th, 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 | 1972671287 | NPPES |
| Alabama | Other | 051117803 | BCBS |
| Alabama | MEDICAID | 129871 | BCBS |
| Alabama | MEDICAID | 01356513 | BCBS |
| Alabama | Other | 051117804 | BCBS |
| Alabama | MEDICAID | 129875 | BCBS |
| Alabama | MEDICAID | 129873 | BCBS |
| Alabama | Other | 051117802 | BCBS |
| Alabama | Other | 051117806 | BCBS |
| Alabama | MEDICAID | 129872 | BCBS |
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