Organization
MUHAMMAD EJAZ ATA
Active
Organization
MUHAMMAD EJAZ ATA
Active
Other names
Pisgah Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD EJAZ ATA MD (MEDICAL DIRECTOR)
(256) 451-1250
Entity
Organization
Contact information
Practice address
6110 COUNTY ROAD 88, PISGAH MEDICAL CLINIC, PISGAH, AL 35765
(256) 451-1250
(256) 451-1270
Mailing address
PO BOX 246, 6110 COUNTY ROAD 88, PISGAH, AL 35765
(256) 451-1250
(256) 451-1270
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00000
MD
208000000X
Pediatrics Physician
00000
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011432
BLUE CROSS
AL
05
—
541003864
—
AL
01
—
CM0511
RAILROAD MEDICACRE
—
Enumeration date
08/02/2006
Last updated
10/22/2009
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