Organization
CYRIAC MADATHIKUNNEL, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIRMALA MADATHIKUNNEL (OFFICE MANAGER)
(334) 872-3339
Entity
Organization
Contact information
Practice address
1013 MEDICAL CENTER PKWY, FRIST HOWELL BUILDING # 3, SELMA, AL 36701-6742
(334) 872-3339
(334) 872-6200
Mailing address
1013 MEDICAL CENTER PKWY, FRIST HOWELL BUILDING # 3, SELMA, AL 36701-6742
(334) 872-3339
(334) 872-6200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00019370
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51514539
BCBS OF ALABAMA
AL
05
—
529914120
—
AL
Enumeration date
12/18/2006
Last updated
12/10/2009
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