Healthcare Provider Details

I. General information

NPI: 1992970685
Provider Name (Legal Business Name): ALABAMA NASAL AND SINUS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7191 CAHABA VALLEY RD SUITE 301
BIRMINGHAM AL
35242-6402
US

IV. Provider business mailing address

7191 CAHABA VALLEY RD SUITE 301
BIRMINGHAM AL
35242-6402
US

V. Phone/Fax

Practice location:
  • Phone: 205-980-2091
  • Fax: 205-980-2196
Mailing address:
  • Phone: 205-980-2091
  • Fax: 205-980-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number14772
License Number StateAL

VIII. Authorized Official

Name: DR. MICHAEL J SILLERS
Title or Position: OWNER/DIRECTOR/PHYSICIAN
Credential: MD
Phone: 205-980-2091