Provider Demographics
NPI:1174785281
Name:NORTHERN ALABAMA INTERNISTS, P.C.
Entity type:Organization
Organization Name:NORTHERN ALABAMA INTERNISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VARUN
Authorized Official - Middle Name:R
Authorized Official - Last Name:PUDUCHERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-503-0940
Mailing Address - Street 1:250 CHATEAU DR SW
Mailing Address - Street 2:SUITE 235
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6436
Mailing Address - Country:US
Mailing Address - Phone:256-503-0940
Mailing Address - Fax:
Practice Address - Street 1:250 CHATEAU DR SW
Practice Address - Street 2:SUITE 235
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6436
Practice Address - Country:US
Practice Address - Phone:256-503-0940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPENDINGMedicaid
ALPENDINGOtherBCBS OF AL
ALPENDINGMedicaid