Pallavi    Sunkavalli    MD
Contract Details
American Family Care--Pelham
Facility name
Provider ID
P000001692
NPI
1184878639
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
5/28/2014
Direct Contract
Yes
Term Date
5/28/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2970 Pelham Parkway
Pelham, AL 35124
United States
County
Shelby
Phone
2056216411 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
Specialty Type
Internal Medicine
Map
Address