REALM INCORPORATED NPI 1558616029

NPI Information

REALM INCORPORATED is a primary care clinic center in Dothan, AL. REALM INCORPORATED NPI is 1558616029. The provider is registered as an organization entity type.
The provider Is Doing Business As Nathanael Medical Center.

The provider's business location address is:

1435 W MAIN ST
DOTHAN, AL
ZIP 36301-311
Phone: (334) 702-8872
Fax: (334) 702-8957

The provider's authorized official is Sammy Banner .
The authorized official title is President and has the following contact phone number (334) 702-8872.

The CLIA number assigned to this NPI record is 01D0907301 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/19/2012 and was last updated on 7/19/2012.

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:

Other Identifiers

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

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