| Dcrw Medical Group | |
|
401 Tuscaloosa Ave Sw Ste 210 Birmingham AL 35211-1486 | |
| (205) 291-8842 | |
| (205) 235-9592 |
| Full Name | Dcrw Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 401 Tuscaloosa Ave Sw Ste 210, Birmingham, Alabama |
| Authorized Official Name and Position | Celeste Reese Willis (CEO) |
| Authorized Official Contact | 2052918842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dcrw Medical Group 944 Narrows Point Dr Birmingham AL 35242-8672 Ph: (205) 747-9340 | Dcrw Medical Group 401 Tuscaloosa Ave Sw Ste 210 Birmingham AL 35211-1486 Ph: (205) 291-8842 |
| NPI Number | 1083228597 |
|---|---|
| Provider Enumeration Date | 09/02/2020 |
| Last Update Date | 03/02/2023 |
| Medicare PECOS PAC ID | 1850701764 |
|---|---|
| Medicare Enrollment ID | O20201104002081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083228597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Celeste S Reese Willis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104893809 PECOS PAC ID: 3779552963 Enrollment ID: I20040924000656 |
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