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General NPI Number Information
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NPI Number | 1386052462
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Entity Type | Organization
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Legal Business Name | VALLEY INTERNAL MEDICINE
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Dates
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Enumeration Date | 08/01/2014
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Last Update Date | 08/01/2014
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Provider Practice Location Address
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Address Line | 2208 DANVILLE RD SW SUITE A
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City | DECATUR
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State | AL
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Zip | 35601-4603
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Country | US
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Telephone | 256-686-3386
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Fax | 256-301-5545
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Provider Business Mailing Address
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Address Line | 2208 DANVILLE RD SW SUITE A
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City | DECATUR
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State | AL
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Zip | 35601-4603
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Country | US
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Telephone | 256-686-3386
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Fax | 256-301-5545
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Authorized Official
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Title or Position | OWNER
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Name | DR. AHMAD G SHIKHTHOLTH
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Credential | M.D.
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Telephone | 256-686-3386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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