Healthcare Provider Details

I. General information

NPI: 1679215495
Provider Name (Legal Business Name): NANDAN PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 6TH AVE S
BIRMINGHAM AL
35233-1801
US

IV. Provider business mailing address

833 PRINCETON AVENUE SW PROFESSIONAL OFFICE BUILDING 3, SUITE 200-E
BIRMINGHAM AL
35211
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3450
  • Fax:
Mailing address:
  • Phone: 205-783-7694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number47716
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: