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Organization

REALM INCORPORATED

Active
Other names
NATHANAEL MEDICAL CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAMMY BANNER D.O. (PRESIDENT)
(334) 702-8872
Entity
Organization

Contact information

Practice address
1435 W MAIN ST, DOTHAN, AL 36301-1311
(334) 702-8872
(334) 702-8957
Mailing address
PO BOX 8307, DOTHAN, AL 36304-0307
(334) 702-8872
(334) 702-8957

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
DO190
AL

Other

Enumeration date
07/19/2012
Last updated
07/19/2012
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