Paula    Debroy Monzon    MD
Contract Details
Metro Infectious Disease Consultants
Facility name
Provider ID
P000000001
NPI
1225447162
Tax ID
363966745
Effective Date
6/1/2021
Last Updated
6/8/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
107.00
Fee Schedule Multiplier
Location Details
Address
123 Ana Drive
Florence, AL 35630
United States
Phone
8882206432 (Phone)
Billing Details
Address
901 McClinktock Drive
Suite 202
Burr Ridge, IL 60527
Billing Phone
8882206432
Specialty Type
Infectious Diseases
Map
Address