Basic Information
| Provider Information | |||||||||
| NPI: | 1366730277 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEIKHOLESLAMI | ||||||||
| FirstName: | AZAR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 E COY SMITH HWY | ||||||||
| Address2: | P.O. BOX 1090 (MAILING ADDRESS) | ||||||||
| City: | MOUNT VERNON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365603322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516626700 | ||||||||
| FaxNumber: | 2516626738 | ||||||||
| Practice Location | |||||||||
| Address1: | 4040 MEMORIAL PKWY SW | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358024364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565331970 | ||||||||
| FaxNumber: | 2567056477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2011 | ||||||||
| LastUpdateDate: | 08/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | L.3462SI | AL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.