Vera  Y  Soong    MD
Contract Details
Southeastern Dermatology Center
Facility name
Provider ID
P000001645
NPI
1295829836
Tax ID
631240959
Effective Date
1/1/1996
Last Updated
5/19/2014
Direct Contract
Yes
Term Date
5/19/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
817 Princeton Avenue Southwest Building 2, Suite 302
Birmingham, AL 35211
United States
County
Jefferson
Phone
2057816995 (Phone)
Billing Details
Address
817 Princeton Avenue Southwest
Building 2, Suite 302
Birmingham, AL 35211
Billing Phone
2057816995
Specialty Type
Dermatology
Map
Address