Provider Demographics
NPI:1992970685
Name:ALABAMA NASAL AND SINUS CENTER
Entity type:Organization
Organization Name:ALABAMA NASAL AND SINUS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SILLERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-980-2091
Mailing Address - Street 1:7191 CAHABA VALLEY RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6402
Mailing Address - Country:US
Mailing Address - Phone:205-980-2091
Mailing Address - Fax:205-980-2196
Practice Address - Street 1:7191 CAHABA VALLEY RD
Practice Address - Street 2:SUITE 301
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6402
Practice Address - Country:US
Practice Address - Phone:205-980-2091
Practice Address - Fax:205-980-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14772174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1992970685OtherMEDICARE
AL1992970685OtherRAILROAD MEDICARE
AL051527931Medicare PIN
ALF41748Medicare UPIN