Healthcare Provider Details

I. General information

NPI: 1619609583
Provider Name (Legal Business Name): ASMA VIRJEE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 6TH AVE S
BIRMINGHAM AL
35233-1932
US

IV. Provider business mailing address

2850 VENICE RD APT 3101
BIRMINGHAM AL
35211-7012
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-9650
  • Fax:
Mailing address:
  • Phone: 347-612-3728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberPA.1956
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: