Healthcare Provider Details

I. General information

NPI: 1003868282
Provider Name (Legal Business Name): ANTHONY PETER CIULLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22266 HIGHWAY 25
COLUMBIANA AL
35051-8618
US

IV. Provider business mailing address

22266 HIGHWAY 25
COLUMBIANA AL
35051-8618
US

V. Phone/Fax

Practice location:
  • Phone: 205-669-3138
  • Fax: 205-669-8718
Mailing address:
  • Phone: 205-669-3138
  • Fax: 205-669-8718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00016732
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: