Healthcare Provider Details

I. General information

NPI: 1295825461
Provider Name (Legal Business Name): ADAHLI E MASSEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADAHLI E MASSEY

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 PROFESSIONAL PKWY
AUBURN AL
36830
US

IV. Provider business mailing address

1536 PROFESSIONAL PKWY
AUBURN AL
36830
US

V. Phone/Fax

Practice location:
  • Phone: 334-501-4424
  • Fax: 334-501-1223
Mailing address:
  • Phone: 334-501-4424
  • Fax: 334-501-1223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number00023033
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: