Provider Demographics
NPI:1902980345
Name:NEUROLOGY CHILD AND ADULT PC
Entity Type:Organization
Organization Name:NEUROLOGY CHILD AND ADULT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHALHUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-344-2762
Mailing Address - Street 1:100 MEMORIAL HOSPITAL DR STE 2A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1199
Mailing Address - Country:US
Mailing Address - Phone:251-377-2762
Mailing Address - Fax:251-344-5492
Practice Address - Street 1:100 MEMORIAL HOSPITAL DR STE 2A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1199
Practice Address - Country:US
Practice Address - Phone:251-377-2762
Practice Address - Fax:251-344-5492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF043Medicare PIN
ALD985Medicare ID - Type Unspecified
ALF816Medicare PIN