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General NPI Number Information
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NPI Number | 1912904913
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Entity Type | Individual
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Provider Name | AJIT KAMALAKARRAO NAIDU MD
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 2095 FLORENCE BLVD
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City | FLORENCE
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State | AL
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Zip | 35630-2751
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Country | US
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Telephone | 256-766-2310
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Fax | 256-768-9956
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Provider Business Mailing Address
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Address Line | 2095 FLORENCE BLVD
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City | FLORENCE
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State | AL
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Zip | 35630-2751
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Country | US
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Telephone | 256-766-2310
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Fax | 256-768-9956
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 15209R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME 97412
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD.29028
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License Number State | AL
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