| Shalom Family Practice And Medical Spa Llc. | |
|
333 Whitesport Dr Sw Ste 304 Huntsville AL 35801-3455 | |
| (256) 469-0350 | |
| (256) 291-3611 |
| Full Name | Shalom Family Practice And Medical Spa Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 333 Whitesport Dr Sw Ste 304, Huntsville, Alabama |
| Authorized Official Name and Position | Ibukunoluwa Pickens (OWNER/D.O.) |
| Authorized Official Contact | 2564690350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalom Family Practice And Medical Spa Llc. 333 Whitesport Dr Sw Ste 304 Huntsville AL 35801-3455 Ph: (256) 469-0350 | Shalom Family Practice And Medical Spa Llc. 333 Whitesport Dr Sw Ste 304 Huntsville AL 35801-3455 Ph: (256) 469-0350 |
| NPI Number | 1154020667 |
|---|---|
| Provider Enumeration Date | 02/23/2023 |
| Last Update Date | 04/11/2023 |
| Medicare PECOS PAC ID | 4688049687 |
|---|---|
| Medicare Enrollment ID | O20230405000278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154020667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew T Mccauley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700151396 PECOS PAC ID: 5991952541 Enrollment ID: I20120904000483 |
| Provider Name | Ibukunoluwa Oluwapelumi Kusimo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356792790 PECOS PAC ID: 7214278290 Enrollment ID: I20190402000625 |
Bptcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 311 Longwood Dr, Sw, Huntsville, AL 35801 Phone: 256-534-5946 Fax: 256-534-3041 | |
Inspirational Counseling Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4100 Market St Ste 100, Huntsville, AL 35808 Phone: 256-210-4925 | |
Gleneagles Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1102 Gleneagles Dr Sw, Huntsville, AL 35801 Phone: 256-881-5880 Fax: 256-883-3280 | |
Magnolia Primary Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4245 Balmoral Dr Sw Ste 102, Huntsville, AL 35801 Phone: 256-203-6676 Fax: 833-979-0980 | |
Five Points Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 Pratt Ave Ne, Huntsville, AL 35801 Phone: 256-714-3363 | |
Davis Medical Group, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7850 Memorial Pkwy Sw, Huntsville, AL 35802 Phone: 256-882-0132 Fax: 256-882-1461 | |
Crestani Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2745 Bob Wallace Ave Sw, Suite D, Huntsville, AL 35805 Phone: 256-534-1323 Fax: 256-534-1780 |