Provider Demographics
NPI:1407042898
Name:INFECTIOUS DISEASE&ALLERGY
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE&ALLERGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:VAGHJIMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-333-3911
Mailing Address - Street 1:2702 HOSPITAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-3376
Mailing Address - Country:US
Mailing Address - Phone:205-333-3911
Mailing Address - Fax:205-333-7180
Practice Address - Street 1:2702 HOSPITAL DR STE 200
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3376
Practice Address - Country:US
Practice Address - Phone:205-333-3911
Practice Address - Fax:205-333-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22377207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL52990600Medicaid
ALG98775Medicare UPIN