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General NPI Number Information
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NPI Number | 1376966416
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Entity Type | Organization
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Legal Business Name | SCOTTSBORO PEDIATRICS PC
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Dates
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Enumeration Date | 01/25/2014
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Last Update Date | 01/25/2014
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Provider Practice Location Address
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Address Line | 1508 S BROAD ST SUITE 300
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City | SCOTTSBORO
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State | AL
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Zip | 35768-2667
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Country | US
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Telephone | 256-259-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 1508 S BROAD ST SUITE 300
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City | SCOTTSBORO
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State | AL
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Zip | 35768-2667
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Country | US
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Telephone | 256-259-3600
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. MUHAMMAD AMJAD
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Credential | M.D.
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Telephone | 256-259-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 24797
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License Number State | AL
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