Healthcare Provider Details

I. General information

NPI: 1932441086
Provider Name (Legal Business Name): LALLEH FATIMEH-ADHAMI VIGO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8331 MADISON BLVD STE 100-F
MADISON AL
35758-2070
US

IV. Provider business mailing address

8331 MADISON BLVD STE 100-F
MADISON AL
35758-2070
US

V. Phone/Fax

Practice location:
  • Phone: 256-203-6684
  • Fax: 256-678-9650
Mailing address:
  • Phone: 256-203-6684
  • Fax: 256-678-9650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD.35783
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: