Healthcare Provider Details

I. General information

NPI: 1417171737
Provider Name (Legal Business Name): NOJAN VALADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 05/03/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 VILLAGE PROFESSIONAL DR
OPELIKA AL
36801-2380
US

IV. Provider business mailing address

2570 VILLAGE PROFESSIONAL DR
OPELIKA AL
36801-2380
US

V. Phone/Fax

Practice location:
  • Phone: 334-203-1917
  • Fax:
Mailing address:
  • Phone: 334-203-1917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number62172
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number62172
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number62172
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: