Michael  A  Cosgrove    MD
Contract Details
SportsMed Orthopaedic Surgery & Spine Center
Facility name
Provider ID
P000000347
NPI
1750459616
Tax ID
631262177
Effective Date
9/19/1994
Last Updated
12/1/2015
Direct Contract
Term Date
11/30/2015
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
4715 Whitesburg Drive
Huntsville, AL 35802
United States
County
Madison
Phone
2568815151 (Phone)
Billing Details
Address
Specialty Type
Anesthesiology
Map
Address