Cheryl  R  Goyne    MD
Contract Details
Neurodiagnostic Center
Facility name
Provider ID
P000000639
NPI
1881702041
Tax ID
630956181
Effective Date
9/14/1993
Last Updated
4/14/2014
Direct Contract
Yes
Term Date
5/14/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
790 Montclair Road Suite 210
Birmingham, AL 35213
United States
County
Jefferson
Phone
2055953600 (Phone)
Billing Details
Address
790 Montclair Road
Suite 210
Birmingham, AL 35213
Billing Phone
2055953600
Specialty Type
Pain Medicine
Map
Address