Individual
MR. IMAD KHDAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
209 W SPRING ST, SUITE 200, SYLACAUGA, AL 35150-2973
(256) 245-5241
(256) 245-0194
Mailing address
1816 SUMMIT PL, BIRMINGHAM, AL 35243-3141
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28198
KY
207R00000X
Internal Medicine Physician
30074
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120103
—
AL
05
—
64281983
—
KY
Enumeration date
08/08/2006
Last updated
10/17/2011
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