Healthcare Provider Details

I. General information

NPI: 1508216797
Provider Name (Legal Business Name): MUHAMMAD EHSAN FAQUIH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 SAINT VINCENTS DR
BIRMINGHAM AL
35205
US

IV. Provider business mailing address

1701 1ST AVE S APT 555
BIRMINGHAM AL
35233-1859
US

V. Phone/Fax

Practice location:
  • Phone: 404-539-9737
  • Fax:
Mailing address:
  • Phone: 404-539-9737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number38459
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME165164
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: