Jeffrey    Cusmariu    MD
Contract Details
OrthoSports Associates--Birmingham-St. Vincent's
Facility name
Provider ID
P000000378
NPI
1104894021
Tax ID
275501752
Effective Date
5/16/2012
Last Updated
3/3/2017
Direct Contract
Yes
Term Date
2/28/2017
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
833 St. Vincent's Drive Suite 403
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059390447 (Phone)
Billing Details
Address
P.O. Box 11407
Department 2004
Birmingham, AL 35246
Billing Phone
2059390447
Specialty Type
Surgery, Orthopedic
Map
Address