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Carl
W
Marten
MD
Contract Details
IMC - Monroeville Medical Clinic, PC
Facility name
Provider ID
P000001061
NPI
1205865839
Tax ID
630632327
Effective Date
9/1/1998
Last Updated
11/21/2011
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
16 Medical Center Dr
Monroeville, AL 36460
United States
County
Monroe
Phone
2515753266
(
Phone
)
Billing Details
Address
Specialty Type
Family Practice
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Address