| Lodewick Diabetes Corporation | |
|
3918 Montclair Rd Ste 217 Mountain Brk AL 35213-2418 | |
| (205) 933-7881 | |
| (205) 785-2864 |
| Full Name | Lodewick Diabetes Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 3918 Montclair Rd Ste 217, Mountain Brk, Alabama |
| Authorized Official Name and Position | Johnette Crawford (OFFICE MANAGER) |
| Authorized Official Contact | 2057478991 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lodewick Diabetes Corporation 3918 Montclair Rd Ste 217 Mountain Brk AL 35213-2418 Ph: (205) 933-7881 | Lodewick Diabetes Corporation 3918 Montclair Rd Ste 217 Mountain Brk AL 35213-2418 Ph: (205) 933-7881 |
| NPI Number | 1932137924 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 06/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932137924 | NPI | - | NPPES |
| 78865 | Other | AL | AETNA HEALTH |
| 0051078865 | Other | AL | BLUE CROSS BLUE SHIELD |
| 529804240 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 00015124 (Alabama) | Primary |
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