Healthcare Provider Details

I. General information

NPI: 1255716973
Provider Name (Legal Business Name): ANIS RABBANI NOURANI SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PEDRO ANIS RAHNEMAYE RABBANI NOURANI SR. MD

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9583
  • Fax: 205-975-5983
Mailing address:
  • Phone: 205-638-9583
  • Fax: 205-975-5983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35257
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberMD.35257
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberMD.35257
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: