Provider Demographics
NPI:1508045170
Name:ENDOCRINOLOGY & DIABETES CLINIC
Entity Type:Organization
Organization Name:ENDOCRINOLOGY & DIABETES CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:RAFEEQ
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-766-3003
Mailing Address - Street 1:541 W COLLEGE ST
Mailing Address - Street 2:SUITE3400
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5323
Mailing Address - Country:US
Mailing Address - Phone:256-766-3003
Mailing Address - Fax:256-766-0898
Practice Address - Street 1:541 W COLLEGE ST
Practice Address - Street 2:SUITE3400
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5323
Practice Address - Country:US
Practice Address - Phone:256-766-3003
Practice Address - Fax:256-766-0898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15555207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC33527Medicare UPIN
AL1C 000082867Medicare PIN