Healthcare Provider Details

I. General information

NPI: 1891395638
Provider Name (Legal Business Name): ALP ATIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 UNIVERSITY BLVD
BIRMINGHAM AL
35233-1816
US

IV. Provider business mailing address

2000 2ND AVE S APT 516
BIRMINGHAM AL
35233-2087
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8100
  • Fax:
Mailing address:
  • Phone: 91-737-3629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number5344
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: