Healthcare Provider Details

I. General information

NPI: 1790472181
Provider Name (Legal Business Name): ROSHAN DINPARASTISALEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 SAINT VINCENTS DR
BIRMINGHAM AL
35205-1601
US

IV. Provider business mailing address

120 19TH ST N APT 413
BIRMINGHAM AL
35203-3249
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-7000
  • Fax:
Mailing address:
  • Phone: 240-917-4155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number52981
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: