Basic Information
| Provider Information | |||||||||
| NPI: | 1245366749 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALAM | ||||||||
| FirstName: | EHSAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4601 PARK RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282093239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043232000 | ||||||||
| FaxNumber: | 7043232000 | ||||||||
| Practice Location | |||||||||
| Address1: | 1604 MEDICAL DR | ||||||||
| Address2: | |||||||||
| City: | LAURINBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283525524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043232000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 03/14/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 57.008379 | OH | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | N3431 | TX | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 046226 | CT | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | D0066820 | MD | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | ME 102314 | FL | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2081P2900X | 2012-00986 | NC | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.