Individual
PREM KUMAR GULATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1868 SPARKMAN DR NW, HUNTSVILLE, AL 35816-1122
(256) 721-9916
(256) 721-9973
Mailing address
1868 SPARKMAN DR NW, HUNTSVILLE, AL 35816-1122
(256) 721-9916
(256) 721-9973
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
00010377
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009912735
—
AL
05
—
051506668
—
AL
01
—
51509746
BLUE CROSS
AL
01
—
631287696
PROVIDER TAX ID
AL
Enumeration date
09/08/2005
Last updated
07/08/2007
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