National Provider Identifier Database

IMC PEDIATRIC ADOLESCENT MEDICINE LLC
Adolescent Medicine

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.


Contact Information

IMC-PEDIATRIC & ADOLESCENT MEDICINE, LLC
4013 AIRPORT BLVD STE C
MOBILE, AL36608-2201
Phone: 251-435-5437
Fax: 251-435-6744
Website:
Specialty Taxonomy Code
* Adolescent Medicine 2080A0000X

* Indicates primary specialty

NPI Profile & details for IMC-PEDIATRIC & ADOLESCENT MEDICINE, LLC

NPI Number 1205905361
Legal business name
LBN
IMC-PEDIATRIC & ADOLESCENT MEDICINE, LLC
Authorized official ANTHONY PALAZZO - (VICE PRESIDENT OF FINANCE)
Entity Organization
Organization subpart No
Enumeration date 11/06/2006
Last updated 06/26/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AL Medicaid: 529801010
  • AL Other: 51032409 AL BCBS
  • AL Other: 51032411 AL BCBS
  • AL Other: 51032412 AL BCBS
  • AL Other: 51032413 AL BCBS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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