Provider Demographics
NPI:1851147045
Name:MIDTOWN MEDICAL MOBILE LLC
Entity type:Organization
Organization Name:MIDTOWN MEDICAL MOBILE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ MED DIRECTOR/ CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATHIRA
Authorized Official - Middle Name:UPENDRAN
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-234-1625
Mailing Address - Street 1:2055 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1701
Mailing Address - Country:US
Mailing Address - Phone:251-234-1625
Mailing Address - Fax:
Practice Address - Street 1:2055 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-1701
Practice Address - Country:US
Practice Address - Phone:251-234-1625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty