Siddharth  R  Shah    MD
Contract Details
Norwood Clinic
Facility name
Provider ID
P000007277
NPI
1194770461
Tax ID
630715625
Effective Date
1/1/2017
Last Updated
3/30/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
2038 Springdale Lane
Birmingham, AL 35217
United States
County
Jefferson
Phone
2058417665 (Phone)
Billing Details
Address
P.O. Box 830230
Birmingham, AL 35283
Billing Phone
2052506846
Specialty Type
Family Practice
Map
Address