Provider Demographics
NPI:1083644827
Name:ZAHRADKA, SANDRA LOU (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LOU
Last Name:ZAHRADKA
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 1:7500 HUGH DANIEL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7148
Mailing Address - Country:US
Mailing Address - Phone:205-408-4488
Mailing Address - Fax:205-405-1504
Practice Address - Street 1:7500 HUGH DANIEL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7148
Practice Address - Country:US
Practice Address - Phone:205-408-4488
Practice Address - Fax:205-405-1504
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00018417174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE69765Medicare UPIN
AL28068Medicare ID - Type UnspecifiedPROVIDER #