Healthcare Provider Details

I. General information

NPI: 1619961000
Provider Name (Legal Business Name): SAKINA A KAMAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 09/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WATERMELON RD
NORTHPORT AL
35473-5197
US

IV. Provider business mailing address

4401 WATERMELON RD
NORTHPORT AL
35473-5197
US

V. Phone/Fax

Practice location:
  • Phone: 205-343-2811
  • Fax: 205-391-0900
Mailing address:
  • Phone: 205-343-2811
  • Fax: 205-391-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number16537
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: