Unknown Individual – Internal Medicine Physician, NPI 1700100963
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
South Main Street, Evergreen, Blacksburg, Montgomery County, Virginia, 24061, United States
EVERGREEN, AL 364013325
Phone: (251) 578-1163
Type: Location
507, Holmes Avenue Northeast, Old Town Historic District, Five Points, Huntsville, Madison County, Alabama, 35801, United States
HUNTSVILLE, AL 358014144
Phone: (256) 539-0545
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 36401)
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