Provider Demographics
NPI:1447260914
Name:AVSAR, SADRI M (MD)
Entity type:Individual
Prefix:
First Name:SADRI
Middle Name:M
Last Name:AVSAR
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:PO BOX 830525
Mailing Address - Street 2:DEPT SB004
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0525
Mailing Address - Country:US
Mailing Address - Phone:205-266-4631
Mailing Address - Fax:949-703-7371
Practice Address - Street 1:5000 MEDICAL WEST WAY
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-7082
Practice Address - Country:US
Practice Address - Phone:205-266-4631
Practice Address - Fax:205-481-8487
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11653207R00000X
ALMD11653208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009936837Medicaid
AL515-31787OtherBCBS
AL009936837Medicaid
ALC78818Medicare UPIN