Healthcare Provider Details

I. General information

NPI: 1033187505
Provider Name (Legal Business Name): SAHAR ABOUL RAHIM FATHALLAH-SHAYKH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAHAR ABDOULRAHIM TARIF MD

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
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: 205-638-9781
  • Fax: 205-638-2517
Mailing address:
  • Phone: 205-638-9781
  • Fax: 205-638-2517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberMD.29243
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: