Healthcare Provider Details

I. General information

NPI: 1265495378
Provider Name (Legal Business Name): BALASUNDARAM CHANDRA SEKAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 06/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 BROOKWOOD MEDICAL CTR DR
BIRMINGHAM AL
35209-6804
US

IV. Provider business mailing address

PO BOX 678746
DALLAS TX
75267-8746
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-1990
  • Fax: 205-824-8111
Mailing address:
  • Phone: 205-824-8000
  • Fax: 205-824-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number10068
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: