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Kayla
D
Dyer
CRNP
Contract Details
Metro Infectious Disease Consultants
Facility name
Provider ID
P000008524
NPI
1992257323
Tax ID
417353559
Effective Date
12/9/2016
Last Updated
12/9/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
107.00
Fee Schedule Multiplier
Location Details
Address
1102 Monroe Street Southwest
Huntsville, AL 35801
United States
County
Madison
Phone
2564697200
(
Phone
)
Billing Details
Address
901 McClintock Drive
Suite 202
Burr Ridge, IL 60527
Billing Phone
8882206432
Specialty Type
Nurse Practitioner
Map
Address