=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760437925
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KHALEEL K ASHRAF M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2006
-----------------------------------------------------
Last Update Date | 09/30/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 513 BROOKWOOD BLVD STE 275
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35209-6862
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-502-4700
-----------------------------------------------------
Fax | 205-502-5183
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 131329
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35213-6329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-271-8541
-----------------------------------------------------
Fax | 205-271-8555
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 25237
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------