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General NPI Number Information
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NPI Number | 1619265303
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Entity Type | Organization
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Legal Business Name | UNIVERSITY SOUTH ALABAMA CHILDREN'S AND WOMEN'S HOSPITAL
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 1700 CENTER ST
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City | MOBILE
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State | AL
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Zip | 36604-3301
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Country | US
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Telephone | 251-415-1540
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Fax | 251-415-1028
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Provider Business Mailing Address
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Address Line | 1700 CENTER ST
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City | MOBILE
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State | AL
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Zip | 36604-3301
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Country | US
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Telephone | 251-415-1540
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Fax | 251-415-1028
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Authorized Official
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Title or Position | COLLABORATING PHYSICIAN
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Name | DR. HAMAYUN IMRAN
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Credential | M.D.
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Telephone | 251-405-5115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 1-114977
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License Number State | AL
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