Provider Demographics
NPI:1124045083
Name:GOLI, SUNIL KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:KUMAR
Last Name:GOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1022 1ST STREET NORTH
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8725
Mailing Address - Country:US
Mailing Address - Phone:205-664-7852
Mailing Address - Fax:205-664-7822
Practice Address - Street 1:1004 1ST ST N
Practice Address - Street 2:SUITE 350
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8766
Practice Address - Country:US
Practice Address - Phone:205-664-7852
Practice Address - Fax:205-664-7822
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND92692084N0400X
AL288442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H87970Medicare UPIN