Provider Demographics
NPI:1447696406
Name:IMAM, MOHAMAD (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:
Last Name:IMAM
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 1:1 INDEPENDENCE PLAZA
Mailing Address - Street 2:SUITE 900
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2643
Mailing Address - Country:US
Mailing Address - Phone:205-271-8000
Mailing Address - Fax:205-271-8050
Practice Address - Street 1:1 INDEPENDENCE PLAZA
Practice Address - Street 2:SUITE 900
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2643
Practice Address - Country:US
Practice Address - Phone:205-271-8000
Practice Address - Fax:205-271-8050
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN56257207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty