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Lewis
G
Coumanis
MD
Contract Details
USA Health System
Facility name
Provider ID
P000000352
NPI
1184831471
Tax ID
630725648
Effective Date
9/25/2005
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2451 Fillingim Street
Mobile, AL 36617
United States
County
Mobile
Phone
2514717150
(
Phone
)
Billing Details
Address
P.O. Box 40480
Mobile, AL 36604
Specialty Type
Radiology, Diagnostic
Map
Address