Provider Demographics
NPI:1548479728
Name:UNIVERSITY WALKIN FAMILY CARE
Entity type:Organization
Organization Name:UNIVERSITY WALKIN FAMILY CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJAPPA
Authorized Official - Middle Name:
Authorized Official - Last Name:EKAMBARAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-890-8700
Mailing Address - Street 1:4296 UNIVERSITY DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-3006
Mailing Address - Country:US
Mailing Address - Phone:256-890-8700
Mailing Address - Fax:256-890-8989
Practice Address - Street 1:4296 UNIVERSITY DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-3006
Practice Address - Country:US
Practice Address - Phone:256-890-8700
Practice Address - Fax:256-890-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG13602Medicare UPIN
ALC71400Medicare UPIN