Healthcare Provider Details

I. General information

NPI: 1396759452
Provider Name (Legal Business Name): NARESH PUROHIT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 QUINTARD AVE
ANNISTON AL
36201-5754
US

IV. Provider business mailing address

516 QUINTARD AVE
ANNISTON AL
36201-5754
US

V. Phone/Fax

Practice location:
  • Phone: 256-741-9799
  • Fax: 256-741-9795
Mailing address:
  • Phone: 256-741-9799
  • Fax: 256-741-9795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15626
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: