Healthcare Provider Details

I. General information

NPI: 1033136742
Provider Name (Legal Business Name): PAOLA DORATO IQBAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR SW
HUNTSVILLE AL
35801-6455
US

IV. Provider business mailing address

PO BOX 5538
FRESNO CA
93755-5538
US

V. Phone/Fax

Practice location:
  • Phone: 256-880-4187
  • Fax: 256-880-4797
Mailing address:
  • Phone: 559-436-1000
  • Fax: 559-354-4235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number19897
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number041282
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number041282
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: