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Individual

DR. FAZLUL HAQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7101 US HIGHWAY 90 STE 103, DAPHNE, AL 36526-9510
(256) 701-5651
(256) 429-9411
Mailing address
600 SUN TEMPLE DR, MADISON, AL 35758-8643
(256) 288-3333
(256) 288-3334

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
191787
NY
2084P0800X
Psychiatry Physician
Primary
MD.50770
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00246075
NY
Enumeration date
10/16/2006
Last updated
03/14/2025
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