| Im Clinic Llc | |
|
420 Lowell Dr Se Ste 102 Huntsville AL 35801-3755 | |
| (256) 258-9278 | |
| Not Available |
| Full Name | Im Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 420 Lowell Dr Se Ste 102, Huntsville, Alabama |
| Authorized Official Name and Position | Omer Iqbal (OWNER) |
| Authorized Official Contact | 2562589278 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Im Clinic Llc Po Box 527 Huntsville AL 35804-0527 Ph: (256) 258-9278 | Im Clinic Llc 420 Lowell Dr Se Ste 102 Huntsville AL 35801-3755 Ph: (256) 258-9278 |
| NPI Number | 1609378520 |
|---|---|
| Provider Enumeration Date | 03/07/2018 |
| Last Update Date | 01/02/2023 |
| Medicare PECOS PAC ID | 6507121969 |
|---|---|
| Medicare Enrollment ID | O20180606000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609378520 | NPI | - | NPPES |
| PENDING | Other | PENDING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | DO.1670 (Alabama) | Secondary |
| Provider Name | Omer Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255713327 PECOS PAC ID: 5395032478 Enrollment ID: I20170809001492 |
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