Provider Demographics
NPI:1467441741
Name:AVULA, SAI (MD)
Entity Type:Individual
Prefix:DR
First Name:SAI
Middle Name:
Last Name:AVULA
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 1:1118 ROSS CLARK CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3001
Mailing Address - Country:US
Mailing Address - Phone:334-794-1148
Mailing Address - Fax:334-793-1954
Practice Address - Street 1:1118 ROSS CLARK CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3001
Practice Address - Country:US
Practice Address - Phone:334-794-1148
Practice Address - Fax:334-793-1954
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28778207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1467441741Medicaid
AL105083Medicaid
ALP00674063OtherMEDICARE RAILROAD
AL051548519OtherBCBS
ALP00674063OtherMEDICARE RAILROAD
AL1467441741Medicaid