Provider Demographics
NPI:1982765061
Name:MOHAMMAD KAMRAN
Entity Type:Organization
Organization Name:MOHAMMAD KAMRAN
Other - Org Name:CARDIOLOGY & CARDIOVASCULAR SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-258-1154
Mailing Address - Street 1:1700 CHRISTINE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-3813
Mailing Address - Country:US
Mailing Address - Phone:256-238-1154
Mailing Address - Fax:256-240-8080
Practice Address - Street 1:1700 CHRISTINE AVE STE 100
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-3813
Practice Address - Country:US
Practice Address - Phone:256-238-1154
Practice Address - Fax:256-240-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18732207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51094711OtherGROUP
AL529912350Medicaid
ALI885Medicare ID - Type UnspecifiedMEDCARE GROUP
AL51094711OtherGROUP