Christopher    Hubauer    PA-C
Contract Details
Facility name
Provider ID
P000000001
NPI
1801335385
Tax ID
364907908
Effective Date
4/18/2019
Last Updated
4/16/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
1021 Montgomery Hwy
Vestavia Hills, AL 35216
United States
Phone
205-971-3356 (Phone)
Billing Details
Address
P.O. Box 24568
Belfast, ME 04915
Billing Phone
877-848-1457
Specialty Type
Surgery, Orthopedic
Map
Address