Provider Demographics
NPI:1215960786
Name:ALNAS, WAIL (MD)
Entity type:Individual
Prefix:
First Name:WAIL
Middle Name:
Last Name:ALNAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 405827
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-5827
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 BAPTIST BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705
Practice Address - Country:US
Practice Address - Phone:662-244-2288
Practice Address - Fax:662-244-2763
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18719207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL73014655OtherBLUE CROSS BLUE SHIELD
3021118831Medicare PIN
MS00984324Medicaid
MS830000077Medicare PIN
E90340Medicare UPIN
E90340Medicare UPIN