Provider Demographics
NPI:1073595773
Name:PREMIER INTERNAL MEDICINE, P.C.
Entity Type:Organization
Organization Name:PREMIER INTERNAL MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:N M
Authorized Official - Last Name:NDOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-929-0500
Mailing Address - Street 1:310 GREENO RD S
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-1905
Mailing Address - Country:US
Mailing Address - Phone:251-929-0500
Mailing Address - Fax:251-929-0505
Practice Address - Street 1:310 S GREENO RD
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1905
Practice Address - Country:US
Practice Address - Phone:251-929-0500
Practice Address - Fax:251-929-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty