Healthcare Provider Details

I. General information

NPI: 1851147045
Provider Name (Legal Business Name): MIDTOWN MEDICAL MOBILE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 AIRPORT BLVD
MOBILE AL
36606-1701
US

IV. Provider business mailing address

2055 AIRPORT BLVD
MOBILE AL
36606-1701
US

V. Phone/Fax

Practice location:
  • Phone: 251-234-1625
  • Fax:
Mailing address:
  • Phone: 251-234-1625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ATHIRA UPENDRAN NAIR
Title or Position: CEO/ MED DIRECTOR/ CO OWNER
Credential:
Phone: 251-234-1625