Healthcare Provider Details

I. General information

NPI: 1841245602
Provider Name (Legal Business Name): INFECTIOUS DISEASE ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 BROOKWOOD MEDICAL CTR DR SUITE 403
BIRMINGHAM AL
35209-6808
US

IV. Provider business mailing address

2022 BROOKWOOD MEDICAL CTR DR SUITE 403
BIRMINGHAM AL
35209-6808
US

V. Phone/Fax

Practice location:
  • Phone: 205-870-9740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SHARON L LITTLE
Title or Position: OFFICE MANAGER
Credential:
Phone: 205-870-9740