Provider Demographics
NPI:1336121458
Name:VORA, AMIT V (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:V
Last Name:VORA
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 1:301 PINE ST NW
Mailing Address - Street 2:STE C
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-2338
Mailing Address - Country:US
Mailing Address - Phone:256-773-0770
Mailing Address - Fax:256-773-2509
Practice Address - Street 1:301 PINE ST NW
Practice Address - Street 2:STE C
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-2338
Practice Address - Country:US
Practice Address - Phone:256-773-0770
Practice Address - Fax:256-773-2509
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00007819207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510 46493OtherBC
AL000046493Medicaid
AL000046493Medicaid