Healthcare Provider Details
I. General information
NPI: 1205190360
Provider Name (Legal Business Name): HAMEED IQBAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/03/2012
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 ROSA LN
FLORENCE AL
35630-1770
US
IV. Provider business mailing address
PO BOX 2587
MUSCLE SHOALS AL
35662-2587
US
V. Phone/Fax
- Phone: 607-428-5074
- Fax: 607-758-8210
- Phone: 256-383-4473
- Fax: 256-320-7280
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 41926 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 41926 |
| License Number State | AL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 280131 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: