Provider Demographics
NPI:1548378755
Name:SAADAT ANSARI, MD, LLC
Entity Type:Organization
Organization Name:SAADAT ANSARI, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAADAT
Authorized Official - Middle Name:H
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-536-9604
Mailing Address - Street 1:201 LONGWOOD DRIVE, SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-536-9604
Mailing Address - Fax:256-536-9606
Practice Address - Street 1:201 LONGWOOD DRIVE, SE
Practice Address - Street 2:SUITE B
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-536-9604
Practice Address - Fax:256-536-9606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALDD6592OtherRAILROAD MEDICARE
AL529911220Medicaid
ALDD6592OtherRAILROAD MEDICARE
ALJ371Medicare PIN