MEDICARE: JULIO ALEJANDRO CHALELA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084A2900X	Neurocritical Care Physician	27965	SC
2	2084N0400X	Neurology Physician	2020-02949	NC
3	2084N0400X	Neurology Physician	27965	SC
4	2084A2900X	Neurocritical Care Physician	MD.49326	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548200371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIO ALEJANDRO CHALELA MD

Provider Business Mailing Address
First Line	:	PO BOX 746450
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6450
Country	:	US
Telephone Number	:	866-401-3057
Fax Number	:	318-868-6430

Provider Business Practice Location Address
First Line	:	6701 AIRPORT BLVD STE A203
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-3763
Country	:	US
Telephone Number	:	251-665-8290
Fax Number	:	251-410-4862

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	10/17/2024

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