Individual
MUHAMMAD EJAZ ATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6110 COUNTY ROAD 88, PISGAH MEDICAL CLINIC, PISGAH, AL 35765
(256) 451-1250
(256) 451-1270
Mailing address
PO BOX 246, 6110 COUNTY ROAD 88, PISGAH, AL 35765-0246
(256) 451-1250
(256) 451-1270
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16386
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000087667
—
AL
05
—
009910886
—
AL
01
—
051087667
BLUE CROSS OF ALABAMA
AL
01
—
051523907
BLUE CROSS OF ALABAMA
AL
01
—
110061830
RAILROAD MEDICARE
AL
05
—
529900820
—
AL
05
—
541003864
—
AL
05
—
541386401
—
AL
Enumeration date
09/08/2006
Last updated
02/23/2009
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