Siddharth    Shah    MD
Contract Details
Tarrant Medical
Facility name
Provider ID
P000000001
NPI
1194770461
Tax ID
872183228
Effective Date
2/14/2022
Last Updated
2/24/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
2038 Springdale Lane
Tarrant, AL 35217
United States
Phone
205-841-7665 (Phone)
Billing Details
Address
2038 Springdale Lane
Tarrant, AL 35217
Billing Phone
205-841-7665
Specialty Type
Family Practice
Map
Address