# INTERFACE MEDICAL CONSULTING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881182236
- **Authorized official:** STEPHANIE INGENITO (CREDENTIALING SPECIALISTS)
- **Authorized official phone:** (570) 352-3063

## Contact information

- **Practice address:** 12141 CRI, FAIRHOPE, AL 36532
- **Practice address phone:** (251) 689-7168
- **Mailing address:** PO BOX 146, FAIRHOPE, AL 36533-0146
- **Mailing address phone:** (251) 689-7168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2018
- **Last updated:** 05/01/2018