Provider Demographics
NPI:1235472192
Name:JIWANI, ALISHA Z (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:Z
Last Name:JIWANI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 UNIVERSITY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-2313
Mailing Address - Country:US
Mailing Address - Phone:832-418-9606
Mailing Address - Fax:
Practice Address - Street 1:2208 UNIVERSITY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2313
Practice Address - Country:US
Practice Address - Phone:832-418-9606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37123207Q00000X
NY281343208600000X
TXR1392208600000X
CT56598390200000X
390200000X
ALMD.37123208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program