Provider Demographics
NPI:1164439709
Name:ARYANPURE, MOHAMMAD FAWAD (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:FAWAD
Last Name:ARYANPURE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 DOWNING RDG
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-3642
Mailing Address - Country:US
Mailing Address - Phone:205-507-1100
Mailing Address - Fax:205-553-3318
Practice Address - Street 1:7005 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-3990
Practice Address - Country:US
Practice Address - Phone:205-345-4862
Practice Address - Fax:205-330-0228
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27529207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine