Healthcare Provider Details

I. General information

NPI: 1871040915
Provider Name (Legal Business Name): BILAL KAMAL ALAM M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5126 HOSPITAL DR NE
COVINGTON GA
30014-2566
US

IV. Provider business mailing address

1338 STANLEY PARK DR
DECATUR GA
30033-4429
US

V. Phone/Fax

Practice location:
  • Phone: 631-480-3356
  • Fax:
Mailing address:
  • Phone: 631-480-3356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number62685
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number96367
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number57.027691
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: