Individual
MRS. KETA KIRAN VAIDYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
420 LOWELL DR SE, SUITE 204, HUNTSVILLE, AL 35801-3754
(256) 536-9031
(256) 539-4240
Mailing address
420 LOWELL DR SE, SUITE 204, HUNTSVILLE, AL 35801-3754
(256) 536-9031
(256) 539-4240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
241589
MA
207RG0100X
Gastroenterology Physician
Primary
90364
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174846
—
AL
Enumeration date
06/24/2009
Last updated
09/25/2015
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