Organization
INTERFACE MEDICAL CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE INGENITO (CREDENTIALING SPECIALISTS)
(570) 352-3063
Entity
Organization
Contact information
Practice address
12141 CRI, FAIRHOPE, AL 36532
(251) 689-7168
Mailing address
PO BOX 146, FAIRHOPE, AL 36533-0146
(251) 689-7168
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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