Provider Demographics
NPI:1396019550
Name:HUNTSVILLE NEUROLOGY
Entity Type:Organization
Organization Name:HUNTSVILLE NEUROLOGY
Other - Org Name:RAO R NADELLA, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAO
Authorized Official - Middle Name:R
Authorized Official - Last Name:NADELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-519-9181
Mailing Address - Street 1:333 WHITESPORT DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3455
Mailing Address - Country:US
Mailing Address - Phone:256-519-9181
Mailing Address - Fax:256-519-9141
Practice Address - Street 1:333 WHITESPORT DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3455
Practice Address - Country:US
Practice Address - Phone:256-519-9181
Practice Address - Fax:256-519-9141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21198282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG25303Medicare UPIN