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Jack
L
Zaremba
MD
Contract Details
Trinity Medical Clinics
Facility name
Provider ID
P000001923
NPI
1104918309
Tax ID
631059170
Effective Date
1/1/1996
Last Updated
6/3/2013
Direct Contract
Yes
Term Date
6/3/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
5890 Valley Road Suite 200
Birmingham, AL 35235
United States
County
Jefferson
Phone
2056557600
(
Phone
)
Billing Details
Address
Specialty Type
Internal Medicine
Map
Address