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Marc
A
Michelson
MD
Contract Details
Norwood Clinic
Facility name
Provider ID
P000001154
NPI
1720081961
Tax ID
630715625
Effective Date
3/1/1999
Last Updated
4/17/2015
Direct Contract
Yes
Term Date
6/7/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1 Independence Drive Suite 700
Birmingham, AL 35209
United States
County
Jefferson
Phone
2052506042
(
Phone
)
Billing Details
Address
P.O. Box 830230
Birmingham, AL 35283
Billing Phone
2052506846
Specialty Type
Ophthalmology
Map
Address