Provider Demographics
NPI:1366730277
Name:SHEIKHOLESLAMI, AZAR (MD)
Entity type:Individual
Prefix:MS
First Name:AZAR
Middle Name:
Last Name:SHEIKHOLESLAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 E COY SMITH HWY
Mailing Address - Street 2:P.O. BOX 1090 (MAILING ADDRESS)
Mailing Address - City:MOUNT VERNON
Mailing Address - State:AL
Mailing Address - Zip Code:36560-3322
Mailing Address - Country:US
Mailing Address - Phone:251-662-6700
Mailing Address - Fax:251-662-6738
Practice Address - Street 1:4040 MEMORIAL PKWY SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-4364
Practice Address - Country:US
Practice Address - Phone:256-533-1970
Practice Address - Fax:256-705-6477
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL.3462SI2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry