Basic Information
| Provider Information | |||||||||
| NPI: | 1831121441 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIHA | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4040 MEMORIAL PKWY SW | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358024364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567056454 | ||||||||
| FaxNumber: | 2567056356 | ||||||||
| Practice Location | |||||||||
| Address1: | 4040 MEMORIAL PKWY SW | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358024364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567056454 | ||||||||
| FaxNumber: | 2567056356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 09/05/2008 | ||||||||
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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 | 2084P0805X | 15587 | AL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 009976665 | 05 | AL | MEDICAID | 515-90930 | 01 | AL | BLUE CROSS BLUE SHIELD OF ALABAMA | OTHER | 000084584 | 05 | AL | MEDICAID |