Healthcare Provider Details

I. General information

NPI: 1295207520
Provider Name (Legal Business Name): ROSS BRIDGE MEDICAL PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2018
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 MARKET ST STE A
BIRMINGHAM AL
35226-6391
US

IV. Provider business mailing address

3635 MARKET ST STE A
HOOVER AL
35226-6391
US

V. Phone/Fax

Practice location:
  • Phone: 205-494-7677
  • Fax:
Mailing address:
  • Phone: 205-494-7677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MADHAV DEVANI
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 205-494-7677