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EASTERN SHORE INTERNAL MEDICINE LLC NPI 1891090403


NPI Information

NPI: 1891090403
Provider Name: EASTERN SHORE INTERNAL MEDICINE, LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 01D2020982

Address:
374 GREENO RD S
FAIRHOPE, AL
ZIP 36532
Phone: (251) 990-1770
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EASTERN SHORE INTERNAL MEDICINE, LLC is an internal medicine in Fairhope, AL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. EASTERN SHORE INTERNAL MEDICINE, LLC NPI is 1891090403. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

374 GREENO RD S
FAIRHOPE, AL
ZIP 36532-916
Phone: (251) 990-1770
Fax: (251) 990-1771

The provider's authorized official is Richard L. Snellgrove .
The authorized official title is Physician and has the following contact phone number (251) 990-1770.

The CLIA number assigned to this NPI record is 01D2020982 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/13/2011 and was last updated on 2/21/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine00016922ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
125-10092OTHERALABAMAUNITED HEALTHCARE
2510-38007OTHERALABAMABC/BS
3E51006MEDICARE UPINALABAMA
4000038007MEDICAIDALABAMA
5000038007MEDICARE PINALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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