Provider Demographics
NPI:1992002356
Name:MOBILE PHYSICAL MEDICINE & WELLNESS
Entity Type:Organization
Organization Name:MOBILE PHYSICAL MEDICINE & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:SCHNITZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-450-8044
Mailing Address - Street 1:3929 AIRPORT BLVD
Mailing Address - Street 2:BUILDING 2, SUITE 100
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1987
Mailing Address - Country:US
Mailing Address - Phone:251-450-8044
Mailing Address - Fax:251-272-8913
Practice Address - Street 1:3929 AIRPORT BLVD
Practice Address - Street 2:BUILDING 2, SUITE 100
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1987
Practice Address - Country:US
Practice Address - Phone:251-450-8044
Practice Address - Fax:251-272-8913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20439208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102G700071Medicare PIN
ALE44653Medicare UPIN