Healthcare Provider Details

I. General information

NPI: 1538489190
Provider Name (Legal Business Name): MADHAV DEVANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 MARKET ST STE A
HOOVER 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: 727-999-5581
  • Fax: 866-228-5944
Mailing address:
  • Phone: 727-999-5581
  • Fax: 866-228-5944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD32637
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number32637
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: