Individual
DR. MONEEB M. EHTESHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 GOVERNORS DR SW FL 1, HUNTSVILLE, AL 35801-5171
(256) 533-1600
(256) 539-0856
Mailing address
201 GOVERNORS DR SW FL 1, HUNTSVILLE, AL 35801-5171
(256) 533-1600
(256) 539-0856
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
42923
AL
207T00000X
Neurological Surgery Physician
MC-129
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272208
—
AL
01
—
A13430A
MEDICARE
AL
Enumeration date
04/03/2008
Last updated
01/24/2023
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