Organization
ALABAMA INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EHTISHAM R KHAN M.D (MANAGER)
(256) 714-6686
Entity
Organization
Contact information
Practice address
1107 14TH AVE SE, SUITE G-400, DECATUR, AL 35601-3309
(256) 714-6686
Mailing address
1107 14TH AVE SE, SUITEG-400, DECATUR, AL 35601-3309
(256) 714-6686
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
19019
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109210
—
AL
Enumeration date
12/27/2008
Last updated
08/14/2009
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