Prem Kumar Gulati, M.D.
Individual provider Active NPI Legal Medicine · Huntsville, AL
NPI 1477547149 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1477547149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Legal Medicine 173000000X
- License
- 00010377 (AL)
- Practice address
- 1868 Sparkman Dr NW
Huntsville, AL 35816-1122 - Phone
- (256) 721-9916
- Fax
- (256) 721-9973
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00010377 | AL | MD | Legal Medicine |
| 10377 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleep & Pulmonary Care Center, P.C. | Current |
Accepting new patients |
Locations
3751 Sullivan St
Madison, AL 35758
Phone (256) 772-4211
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 00010377 | AL | Yes |
Addresses
Primary practice location
1868 Sparkman Dr NW
Huntsville, AL 35816-1122
Mailing address
1868 Sparkman Dr NW
Huntsville, AL 35816-1122
Phone (256) 721-9916
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 631287696 | Other | AL | PROVIDER TAX ID |
| 051506668 | Medicaid | AL | |
| 009912735 | Medicaid | AL | |
| 51509746 | Other | AL | BLUE CROSS |
Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.