Eastside Women's Specialists, P.C.

Contacts

Phone	+1 205-838-6224
Fax	2058383953

Authorized person

Name	MRS. SANDY ZABOWSKI
Role	OFFICE MANAGER
Phone	2058386224

Taxonomy

Taxonomy Code	207V00000X - Obstetrics & Gynecology Physician
Is Primary	Yes

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	621111
Sponsor’s telephone number	2058386224
Plan sponsor’s address	48 MEDICAL PARK EAST DR STE 456, BIRMINGHAM, AL, 352353473

Signature of

Role	Plan administrator
Date	2016-10-10
Name of individual signing	DALE M. GREENE, M.D.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	621111
Sponsor’s telephone number	2058386224
Plan sponsor’s address	48 MEDICAL PARK EAST DR STE 456, BIRMINGHAM, AL, 352353473

Signature of

Role	Plan administrator
Date	2016-10-10
Name of individual signing	DALE M. GREENE, M.D.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	621111
Sponsor’s telephone number	2058386224
Plan sponsor’s address	48 MEDICAL PARK EAST DR STE 456, BIRMINGHAM, AL, 352353473

Signature of

Role	Plan administrator
Date	2015-09-28
Name of individual signing	DALE M. GREENE, M.D.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	621111
Sponsor’s telephone number	2058386224
Plan sponsor’s address	48 MEDICAL PARK EAST DR STE 456, BIRMINGHAM, AL, 352353473

Signature of

Role	Plan administrator
Date	2014-10-14
Name of individual signing	DALE M. GREENE, M.D.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	621111
Sponsor’s telephone number	2058386224
Plan sponsor’s address	48 MEDICAL PARK EAST DR STE 456, BIRMINGHAM, AL, 352353473

Signature of

Role	Plan administrator
Date	2013-10-03
Name of individual signing	DALE M. GREENE, M.D.