Provider Demographics
NPI:1568531820
Name:HIGHLANDS INTERNAL MEDICINE LLC
Entity Type:Organization
Organization Name:HIGHLANDS INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SELJUKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-350-2211
Mailing Address - Street 1:2422 DANVILLE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603
Mailing Address - Country:US
Mailing Address - Phone:256-350-2211
Mailing Address - Fax:
Practice Address - Street 1:2422 DANVILLE RD
Practice Address - Street 2:SUITE F
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603
Practice Address - Country:US
Practice Address - Phone:256-350-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21615207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51537676OtherBCBS
=========OtherTAXID