Healthcare Provider Details

I. General information

NPI: 1508587098
Provider Name (Legal Business Name): ALELEGN ENYEW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2022
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 UNIVERSITY BLVD E
TUSCALOOSA AL
35401-2029
US

IV. Provider business mailing address

809 UNIVERSITY BLVD E
TUSCALOOSA AL
35401-2029
US

V. Phone/Fax

Practice location:
  • Phone: 404-265-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number50112
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: