Muhammad  E  Ata    MD
Contract Details
DeKalb Regional Medical Center
Facility name
Provider ID
P000000058
NPI
1023112307
Tax ID
204370870
Effective Date
12/1/2008
Last Updated
6/13/2014
Direct Contract
Yes
Term Date
4/25/2013
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_011
Location Details
Address
6110 County Road 88
Pisgah, AL 35765
United States
County
Jackson
Phone
2564511250 (Phone)
Billing Details
Address
P.O. Box 277507
Atlanta, GA 30384
Billing Phone
2569972317
Specialty Type
Internal Medicine
Map
Address