Daniela    Weatherly    MD
Contract Details
IMC Diagnostic and Medical Clinic
Facility name
Provider ID
P000008239
NPI
1184691859
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
831-C Hillcrest Road
Mobile, AL 36604
United States
County
Mobile
Phone
2516334949 (Phone)
Billing Details
Address
831-C Hillcrest Road
Mobile, AL 36604
Billing Phone
2516334949
Specialty Type
Family Practice
Map
Address