Healthcare Provider Details

I. General information

NPI: 1972165355
Provider Name (Legal Business Name): DHIVYA KUZHANDAI VELU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DHIVYA VELU MD

II. Dates (important events)

Enumeration Date: 07/05/2019
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SIVLEY RD SW
HUNTSVILLE AL
35801-4421
US

IV. Provider business mailing address

101 SIVLEY RD SW
HUNTSVILLE AL
35801-4470
US

V. Phone/Fax

Practice location:
  • Phone: 256-265-1000
  • Fax:
Mailing address:
  • Phone: 256-265-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD46994
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD46994
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: