Healthcare Provider Details

I. General information

NPI: 1750339297
Provider Name (Legal Business Name): ASHRAF AHSAN SYED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2702 HOSPITAL DR SUITE 200
NORTHPORT AL
35476-3376
US

IV. Provider business mailing address

2702 HOSPITAL DR SUITE 200
NORTHPORT AL
35476-3376
US

V. Phone/Fax

Practice location:
  • Phone: 205-333-7075
  • Fax: 205-333-3256
Mailing address:
  • Phone: 205-333-7075
  • Fax: 205-333-3256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number17109
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: