| Imc-eastern Shore Adult Medicine, Llc | |
|
300 Greeno Rd S Suite B Fairhope AL 36532-1905 | |
| (251) 929-3424 | |
| (251) 929-3430 |
| Full Name | Imc-eastern Shore Adult Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 300 Greeno Rd S, Fairhope, Alabama |
| Authorized Official Name and Position | Anthony Palazzo (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 2514351361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imc-eastern Shore Adult Medicine, Llc 300 Greeno Rd S Suite B Fairhope AL 36532-1905 Ph: (251) 929-3424 | Imc-eastern Shore Adult Medicine, Llc 300 Greeno Rd S Suite B Fairhope AL 36532-1905 Ph: (251) 929-3424 |
| NPI Number | 1912284852 |
|---|---|
| Provider Enumeration Date | 11/07/2011 |
| Last Update Date | 11/01/2019 |
| Medicare PECOS PAC ID | 3375718042 |
|---|---|
| Medicare Enrollment ID | O20111207000620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912284852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | (* (Not Available)) | Secondary |
| Provider Name | John C Mcduff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467410530 PECOS PAC ID: 0345270591 Enrollment ID: I20050817000263 |
| Provider Name | Wendy L Davidson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184725715 PECOS PAC ID: 7416856331 Enrollment ID: I20051107001121 |
| Provider Name | Andrew S Dukes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902890171 PECOS PAC ID: 0648271395 Enrollment ID: I20070123000328 |
| Provider Name | Laura E Minto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386791259 PECOS PAC ID: 4486745890 Enrollment ID: I20070814000228 |
| Provider Name | Abdel H Kasmia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821033127 PECOS PAC ID: 3072604495 Enrollment ID: I20080415000667 |
| Provider Name | Sandra Rego Alexander |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1609815091 PECOS PAC ID: 6800958281 Enrollment ID: I20081218000362 |
| Provider Name | James J Griffin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255432894 PECOS PAC ID: 2365342292 Enrollment ID: I20100804000610 |
| Provider Name | Michael A Hennigan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1003971839 PECOS PAC ID: 3971405135 Enrollment ID: I20101020000078 |
| Provider Name | Jennifer Pope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720477151 PECOS PAC ID: 4789903295 Enrollment ID: I20170119001168 |
| Provider Name | Lori H Minto |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1831533983 PECOS PAC ID: 8820397862 Enrollment ID: I20170814003314 |
| Provider Name | Julian Jerrod Jesubatham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659682904 PECOS PAC ID: 7214122167 Enrollment ID: I20180409001104 |
| Provider Name | Wendy L Ledlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831698562 PECOS PAC ID: 0749535771 Enrollment ID: I20180615001114 |
| Provider Name | Tara Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356865992 PECOS PAC ID: 4789939208 Enrollment ID: I20180623000114 |
| Provider Name | Clinton L Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760032510 PECOS PAC ID: 4789916222 Enrollment ID: I20191101000883 |
| Provider Name | Christopher Clarke |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013336940 PECOS PAC ID: 1254632425 Enrollment ID: I20200630001648 |
| Provider Name | Erica Breanne Bortmas-shammaa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871075937 PECOS PAC ID: 9335544527 Enrollment ID: I20210826001361 |
| Provider Name | Jonathan Jason Shammaa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477035681 PECOS PAC ID: 2365847423 Enrollment ID: I20210827000727 |
| Provider Name | Rutwij Joshi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205271400 PECOS PAC ID: 6305136250 Enrollment ID: I20220706000572 |
| Provider Name | Allyn Resch |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1841452661 PECOS PAC ID: 2163659293 Enrollment ID: I20221118000544 |
| Provider Name | Wesley Charles Cowan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932515384 PECOS PAC ID: 0042582967 Enrollment ID: I20230818000474 |
Self Center Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 S Greeno Rd, Suite A, Fairhope, AL 36532 Phone: 251-928-8760 Fax: 251-928-7028 | |
Prestige Telemedicine Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 Cumberland Rd, Fairhope, AL 36532 Phone: 251-517-4411 | |
Infiniti Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 Saint Charles Ct, Fairhope, AL 36532 Phone: 888-212-4243 | |
Fulton G. De Four, Md, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 750 Morphy Ave, Fairhope, AL 36532 Phone: 251-752-8235 | |
Baldwin Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 21950 State Highway 181 Ste A, Fairhope, AL 36532 Phone: 251-621-6520 Fax: 251-621-6521 | |
Self And Self Company, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 Greeno Rd S, Suite A, Fairhope, AL 36532 Phone: 251-928-8760 Fax: 251-928-7028 | |
Shehryar Anjum, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 Morphy Ave, Fairhope, AL 36532 Phone: 251-928-2375 |