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Alicia
S
Baldwin
DO
Contract Details
American Family Care--Alabaster
Facility name
Provider ID
P000000079
NPI
1700853280
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
4/24/2018
Direct Contract
Yes
Term Date
4/24/2018
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
120 Colonial Promenade Parkway
Alabaster, AL 35007
United States
County
Shelby
Phone
2056050495
(
Phone
)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address