Matthew    McLean    MD
Contract Details
IMC Diagnostic and Medical Clinic
Facility name
Provider ID
P000008237
NPI
1699086199
Tax ID
631012832
Effective Date
10/7/2022
Last Updated
10/31/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1720 Springhill Avenue
Mobile, AL 36604
United States
County
Mobile
Phone
2514351200 (Phone)
Billing Details
Address
1720 Springhill Avenue
Mobile, AL 36604
Billing Phone
2514351200
Specialty Type
Neurology
Map
Address