Provider Demographics
NPI:1033136742
Name:DORATO IQBAL, PAOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAOLA
Middle Name:
Last Name:DORATO IQBAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5538
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93755-5538
Mailing Address - Country:US
Mailing Address - Phone:559-436-1000
Mailing Address - Fax:559-354-4235
Practice Address - Street 1:1 HOSPITAL DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6455
Practice Address - Country:US
Practice Address - Phone:256-880-4187
Practice Address - Fax:256-880-4797
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041282207LP3000X
AL19897207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-20410OtherBLUE CROSS CRNA HOSP BASE
AL515-30889OtherBLUE CROSS CRNA PHY. BASE
AL051520410Medicaid
AL515-20410OtherBLUE CROSS CRNA HOSP BASE
AL515-30889OtherBLUE CROSS CRNA PHY. BASE