Healthcare Provider Details

I. General information

NPI: 1558528356
Provider Name (Legal Business Name): ADVANCED INTERNAL MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 STONEGATE TRL STE 100
VESTAVIA HLS AL
35242-2267
US

IV. Provider business mailing address

P O BOX 430125
BIRMINGHAM AL
35243
US

V. Phone/Fax

Practice location:
  • Phone: 205-595-0395
  • Fax: 205-599-9024
Mailing address:
  • Phone: 205-595-0395
  • Fax: 205-599-9024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number00023549
License Number StateAL

VIII. Authorized Official

Name: DR. SHARON BROM CHANEY
Title or Position: OWNER
Credential: MD
Phone: 205-595-0395