Healthcare Provider Details

I. General information

NPI: 1760437925
Provider Name (Legal Business Name): KHALEEL K ASHRAF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BROOKWOOD BLVD STE 275
BIRMINGHAM AL
35209-6862
US

IV. Provider business mailing address

PO BOX 131329
BIRMINGHAM AL
35213-6329
US

V. Phone/Fax

Practice location:
  • Phone: 205-502-4700
  • Fax: 205-502-5183
Mailing address:
  • Phone: 205-271-8541
  • Fax: 205-271-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25237
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: