Provider Demographics
NPI:1962023556
Name:ALKESWANI, AMENA RAJA
Entity type:Individual
Prefix:
First Name:AMENA
Middle Name:RAJA
Last Name:ALKESWANI
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:PO BOX 36263
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35236-6263
Mailing Address - Country:US
Mailing Address - Phone:727-504-5883
Mailing Address - Fax:
Practice Address - Street 1:4721 CHACE CIR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3700
Practice Address - Country:US
Practice Address - Phone:205-266-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL49331207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology