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General NPI Number Information
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NPI Number | 1285084087
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Entity Type | Individual
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Provider Name | JAD CHAMIEH MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2016
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 1725 PINE ST STE 201
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City | MONTGOMERY
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State | AL
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Zip | 36106-1117
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Country | US
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Telephone | 334-293-6858
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 PINE ST STE 201
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City | MONTGOMERY
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State | AL
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Zip | 36106-1109
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Country | US
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Telephone | 334-293-6858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | T-3534
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2016012955
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 42610
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License Number State | AL
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