Provider Demographics
NPI:1902890387
Name:REIDY, ANNE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:REIDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PELHAM AVENUE SW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-759-9269
Mailing Address - Fax:256-759-9187
Practice Address - Street 1:320 PELHAM AVENUE SW
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-759-9269
Practice Address - Fax:256-759-9187
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25744207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL05152296Medicaid
AL05152296Medicaid
AL051522996REIMedicare ID - Type Unspecified