Provider Demographics
NPI:1841581824
Name:IMC-NORTH BALDWIN INTERNAL MEDICINE LLC
Entity Type:Organization
Organization Name:IMC-NORTH BALDWIN INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-1361
Mailing Address - Street 1:2004 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-4163
Mailing Address - Country:US
Mailing Address - Phone:251-937-7910
Mailing Address - Fax:251-937-1846
Practice Address - Street 1:2004 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-4163
Practice Address - Country:US
Practice Address - Phone:251-937-7910
Practice Address - Fax:251-937-1846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty