Ali Zul    Jiwani    MD
Contract Details
American Family Care--Gardendale
Facility name
Provider ID
P000000840
NPI
1750542015
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
5/27/2014
Direct Contract
Yes
Term Date
5/27/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
919 Odum Road
Gardendale, AL 35071
United States
County
Jefferson
Phone
2056316834 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Internal Medicine
Map
Address