Healthcare Provider Details

I. General information

NPI: 1356958748
Provider Name (Legal Business Name): SHIVANGI MANISH ARGADE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S # 512
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

103 OXMOOR GLEN CIR
BIRMINGHAM AL
35211-6448
US

V. Phone/Fax

Practice location:
  • Phone: 208-638-9858
  • Fax:
Mailing address:
  • Phone: 334-300-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number1-157971
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1-157971
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: