Healthcare Provider Details

I. General information

NPI: 1982680252
Provider Name (Legal Business Name): ENT HEAD & NECK SURGERY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 SOUTHLEDGE SUITE 101
BIRMINGHAM AL
35242-2451
US

IV. Provider business mailing address

113 SOUTHLEDGE SUITE 101
BIRMINGHAM AL
35242-2451
US

V. Phone/Fax

Practice location:
  • Phone: 205-991-3141
  • Fax: 205-981-2394
Mailing address:
  • Phone: 205-991-3141
  • Fax: 205-981-2394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SALEEM I. NAVIWALA
Title or Position: OTOLARYNGOLOGY PHYSICIAN
Credential: M.D.
Phone: 205-991-3141