Basic Information
| Provider Information | |||||||||
| NPI: | 1497728547 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DABAL | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55310 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352555310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057319701 | ||||||||
| FaxNumber: | 2052979411 | ||||||||
| Practice Location | |||||||||
| Address1: | 619 19TH ST S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352491900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059344011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2006 | ||||||||
| LastUpdateDate: | 09/15/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | ME94294 | FL | N | Allopathic & Osteopathic Physicians | Surgery | 208G00000X | ME94294 | FL | N | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2086S0129X | 29130 | AL | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 105730 | 05 | AL | MEDICAID | 2737400-00 | 05 | FL | MEDICAID | 105731 | 05 | AL | MEDICAID | 51594572 | 01 | AL | BCBS AL | OTHER | 575239848A | 05 | GA | MEDICAID | 51594570 | 01 | AL | BCBS AL | OTHER | 105729 | 05 | AL | MEDICAID | 09629015 | 05 | MS | MEDICAID | 51594571 | 01 | AL | BCBS AL | OTHER |