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2415 Central Pkwy Ste B Montgomery AL 36106-3140 | |
(205) 271-9970 | |
(205) 271-9971 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2415 Central Pkwy Ste B, Montgomery, Alabama |
Authorized Official Name and Position | Christopher Mark Vanraam (COO) |
Authorized Official Contact | 2057036760 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2 Perimeter Park S Ste 260e Birmingham AL 35243-3208 Ph: (205) 703-6760 | 2415 Central Pkwy Ste B Montgomery AL 36106-3140 Ph: (205) 271-9970 |
NPI Number | 1669129169 |
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Provider Enumeration Date | 03/04/2022 |
Last Update Date | 10/18/2022 |
Medicare PECOS PAC ID | 0143626382 |
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Medicare Enrollment ID | O20220426002625 |
Identifier | Type | State | Issuer |
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1669129169 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Fazal Rahim |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1811097462 PECOS PAC ID: 1557263720 Enrollment ID: I20040127000443 |
Provider Name | Mark H Kalenian |
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Provider Type | Practitioner - Allergy/immunology |
Provider Identifiers | NPI Number: 1972504397 PECOS PAC ID: 9234179367 Enrollment ID: I20081231000031 |
Provider Name | Amy Myers Cajacob |
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Provider Type | Practitioner - Allergy/immunology |
Provider Identifiers | NPI Number: 1265759450 PECOS PAC ID: 6709022007 Enrollment ID: I20151113002448 |
Provider Name | Kelli Stringer |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1720222078 PECOS PAC ID: 2466698238 Enrollment ID: I20231129001777 |
Your Doctor's Office, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8630 Vaughn Rd, Montgomery, AL 36117 Phone: 334-676-4076 Fax: 334-676-4064 | |
Aikam Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2895 Zelda Rd, Montgomery, AL 36106 Phone: 334-245-5969 | |