OrganizationAdvanced Obgyn Pc(<Unavail>)Obstetrics & GynecologyAllopathic & Osteopathic PhysiciansPractice Address250 Chateau Dr SW Ste 100, Huntsville, AL 35801-3497(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 11:26 AM.Profile DetailsProvider ID1215118104Provider TypeOrganizationFull NameAdvanced Obgyn PcOther Name<Unavail>SubpartNoEnumeration Date11/19/2007Last Updated6/3/2015Contact InformationPractice LocationPractice Address250 Chateau Dr SW Ste 100, Huntsville, AL 35801-3497Phone(256) 881-9997Fax(256) 880-3838Mailing LocationMailing Address250 Chateau Dr SW Ste 100, Huntsville, AL 35801-3497Phone(256) 881-9997Fax(256) 880-3838Authorized OfficialNameConrad, Michael J (Md)Phone(256) 881-9997Provider TaxonomiesCodeDescriptionLicenseCode207V00000XPrimaryDescriptionObstetrics & GynecologyAllopathic & Osteopathic PhysiciansLicense22430AlabamaProvider IdentifiersIDDescriptionIssuerID7338022DescriptionOtherIssuerAETNAAlabamaID051517281DescriptionMedicaidIssuerUnlistedAlabamaID7410654DescriptionOtherIssuerUNITED HEALTHCAREAlabamaID051517281DescriptionOtherIssuerMEDICAREAlabamaID51517281DescriptionOtherIssuerBCBS OF ALAlabamaID1823651DescriptionOtherIssuer1ST HEALTH/CCNAlabama