Healthcare Provider Details

I. General information

NPI: 1134172737
Provider Name (Legal Business Name): VESTAVIA MRI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 MONTGOMERY HWY SUITE 110
BIRMINGHAM AL
35216-2749
US

IV. Provider business mailing address

1360 MONTGOMERY HWY SUITE 110
BIRMINGHAM AL
35216-2749
US

V. Phone/Fax

Practice location:
  • Phone: 205-263-4674
  • Fax:
Mailing address:
  • Phone: 205-263-4674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number StateAL

VIII. Authorized Official

Name: DR. SWAID NOFAL SWAID
Title or Position: OWNER
Credential: M.D.
Phone: 205-263-4674