Provider Demographics
NPI:1730176553
Name:SEDLIS, JAMES E (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:SEDLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 5TH AVE S # CPPI110
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1700
Mailing Address - Country:US
Mailing Address - Phone:205-638-9587
Mailing Address - Fax:
Practice Address - Street 1:1600 7TH AVE S # CPPI110
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-638-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.21842207P00000X, 208000000X
CT046936208000000X, 2080S0010X
ALMD.208422080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH28492OtherVIVA HEALTH
AL009943990Medicaid
AL511-08796OtherBCBS
AL1730176553OtherTRICARE SOUTH
AL511-09867OtherBCBS
ALH28492OtherVIVA HEALTH
AL511-08796OtherBCBS