Healthcare Provider Details

I. General information

NPI: 1295828010
Provider Name (Legal Business Name): SHIRIN BANU M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 6TH AVE S COOPER GREEN MERCY HOSPITAL
BIRMINGHAM AL
35233-1601
US

IV. Provider business mailing address

1515 6TH AVE S COOPER GREEN MERCY HOSPITAL
BIRMINGHAM AL
35233-1601
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-3245
  • Fax: 205-918-2328
Mailing address:
  • Phone: 205-930-3245
  • Fax: 205-918-2328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number00025845
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: