| Ross Bridge Medical Practice Llc | |
|
3635 Market St Ste A Birmingham AL 35226-6391 | |
| (205) 494-7677 | |
| Not Available |
| Full Name | Ross Bridge Medical Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3635 Market St Ste A, Birmingham, Alabama |
| Authorized Official Name and Position | Purvi Shah (CEO) |
| Authorized Official Contact | 8134166438 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ross Bridge Medical Practice Llc 7118 Lake Run Cir Vestavia AL 35242-7500 Ph: (205) 494-7677 | Ross Bridge Medical Practice Llc 3635 Market St Ste A Birmingham AL 35226-6391 Ph: (205) 494-7677 |
| NPI Number | 1295207520 |
|---|---|
| Provider Enumeration Date | 12/27/2018 |
| Last Update Date | 12/27/2018 |
| Medicare PECOS PAC ID | 4587995568 |
|---|---|
| Medicare Enrollment ID | O20191004001512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295207520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Archana Balasubramanya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912197443 PECOS PAC ID: 3476647033 Enrollment ID: I20111028000679 |
| Provider Name | Michael Jason Grier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124304928 PECOS PAC ID: 2860655198 Enrollment ID: I20120523000374 |
| Provider Name | Madhav V Devani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538489190 PECOS PAC ID: 0446493795 Enrollment ID: I20130905000501 |
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