Organization
SHOALS GASTROENTEROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABHINANDANA ANANTHARAJU (SOLE MEMBER/PHYSICIAN)
(256) 381-6304
Entity
Organization
Contact information
Practice address
1120 S JACKSON HWY, SUITE 201, SHEFFIELD, AL 35660-5777
(256) 381-6304
(256) 381-6307
Mailing address
PO BOX 298, FLORENCE, AL 35631-0298
(256) 767-7494
(256) 765-0377
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/08/2013
Last updated
10/08/2013
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