OrganizationAdvanced Obgyn PcObstetrics & GynecologyAllopathic & Osteopathic PhysiciansPractice Address250 Chateau Dr SW, Ste 100, Huntsville, AL 35801-6436(256) 881-9997PECOS EnrollmentBased on the most recent information from CMS, provider Advanced Obgyn Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1194128330Provider TypeOrganizationFull NameAdvanced Obgyn PcSubpartNoEnumeration Date10/2/2014Last Updated11/6/2014Contact InformationPractice LocationPractice Address250 Chateau Dr SW, Ste 100, Huntsville, AL 35801-6436Phone(256) 881-9997Fax(256) 880-3838Mailing LocationMailing Address250 Chateau Dr SW, Ste 100, Huntsville, AL 35801-6436Phone(256) 881-9997Fax(256) 880-3838Authorized OfficialNameConrad, Michael M (Owner)Phone(256) 881-9997Provider TaxonomiesCodeDescriptionLicenseCode207V00000XPrimaryDescriptionObstetrics & GynecologyAllopathic & Osteopathic PhysiciansLicense22430AlabamaProvider IdentifiersIDDescriptionIssuerID17281DescriptionMedicaidIssuerUnlistedAlabama