Deborah    Putman    NP
Contract Details
Metro Infectious Disease Consultants
Facility name
Provider ID
P000000001
NPI
1386981322
Tax ID
363966745
Effective Date
12/18/2024
Last Updated
12/26/2024
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
256-349-2533 (Phone)
Billing Details
Address
901 McClintock Drive
Suite 202
Burr Ridge, IL 60527
Billing Phone
6306556748
Specialty Type
Nurse Practitioner
Map
Address