Provider Demographics
NPI:1205687167
Name:RANA, MEHTAB
Entity type:Individual
Prefix:
First Name:MEHTAB
Middle Name:
Last Name:RANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 CHESTNUT OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1689
Mailing Address - Country:US
Mailing Address - Phone:205-441-4963
Mailing Address - Fax:
Practice Address - Street 1:1023 MEDICAL CENTER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-7739
Practice Address - Country:US
Practice Address - Phone:334-874-3463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program