Ryan  M  Baker    MD
Contract Details
Champion Sports Medicine--Birmingham-Greystone
Facility name
Provider ID
P000000076
NPI
1639223985
Tax ID
382617193
Effective Date
3/1/1999
Last Updated
2/19/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
201 Doug Baker Boulevard
Birmingham, AL 35242
United States
County
Shelby
Phone
2054080700 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address