Bala  M  Chennupati    MD
Contract Details
BHC Hamilton / Pyle
Facility name
Provider ID
P000000293
NPI
1922080084
Tax ID
631138193
Effective Date
1/1/1995
Last Updated
11/21/2011
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1200 Military St South
Hamilton, AL 35570
United States
County
Marion
Phone
2059217602 (Phone)
Billing Details
Address
Specialty Type
Internal Medicine
Map
Address