Provider Demographics
NPI:1124910211
Name:DAVE, JAIVAL A (MD)
Entity type:Individual
Prefix:
First Name:JAIVAL
Middle Name:A
Last Name:DAVE
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 1:4371 NARROW LANE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2975
Mailing Address - Country:US
Mailing Address - Phone:334-747-7831
Mailing Address - Fax:334-747-7880
Practice Address - Street 1:4371 NARROW LANE RD STE 100
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2975
Practice Address - Country:US
Practice Address - Phone:334-747-7831
Practice Address - Fax:334-747-7880
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program