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