Healthcare Provider Details

I. General information

NPI: 1316901465
Provider Name (Legal Business Name): BHC - SHELBY INTERNAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 2ND ST NE
ALABASTER AL
35007-8817
US

IV. Provider business mailing address

636 2ND STREET NE
ALABASTER AL
35007-8817
US

V. Phone/Fax

Practice location:
  • Phone: 205-663-5770
  • Fax: 205-620-4610
Mailing address:
  • Phone: 205-663-5770
  • Fax: 205-620-4610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: VALETA D NEAL
Title or Position: PRESIDENT
Credential:
Phone: 205-715-5901