1386951887 NPI number — TANGAYI GITHU MD

Table of content: TANGAYI GITHU MD (NPI 1386951887)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386951887 NPI number — TANGAYI GITHU MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GITHU
Provider First Name:
TANGAYI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386951887
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2006 FRANKLIN ST SE STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35801-4537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-539-0457
Provider Business Mailing Address Fax Number:
256-539-5827

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2006 FRANKLIN ST SE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801-4551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-539-0457
Provider Business Practice Location Address Fax Number:
256-539-5827
Provider Enumeration Date:
09/03/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  32374 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 228614 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 228943 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 229181 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 148192 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 149840 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 228233 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 228984 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 249251 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 148104 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 149602 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 211420 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 247897 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 229124 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 229712 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 236735 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 247862 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 148650 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 247637 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 148154 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 148155 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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