Provider Demographics
NPI:1386052462
Name:VALLEY INTERNAL MEDICINE
Entity type:Organization
Organization Name:VALLEY INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHIKHTHOLTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-686-3386
Mailing Address - Street 1:2208 DANVILLE RD SW
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4603
Mailing Address - Country:US
Mailing Address - Phone:256-686-3386
Mailing Address - Fax:256-301-5545
Practice Address - Street 1:2208 DANVILLE RD SW
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4603
Practice Address - Country:US
Practice Address - Phone:256-686-3386
Practice Address - Fax:256-301-5545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty