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General NPI Number Information
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NPI Number | 1447681762
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Entity Type | Organization
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Legal Business Name | THE ENDOCRINE, DIABETES AND METABOLISM CLINIC P.C
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | 3918 MONTCLAIR ROAD SUITE 217
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City | BIRMINGHAM
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State | AL
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Zip | 35213
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Country | US
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Telephone | 205-802-8474
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Fax |
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Provider Business Mailing Address
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Address Line | 3918 MONTCLAIR ROAD SUITE 217
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City | BIRMINGHAM
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State | AL
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Zip | 35213
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Country | US
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Telephone | 205-802-8474
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Fax | 205-802-8753
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FARAH YASMEEN GHORI-JAVED
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Credential | MD
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Telephone | 205-802-8474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD27794
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License Number State | AL
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