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Valley Medical & Surgical Clinic, P.C.

Details

Name: Valley Medical & Surgical Clinic, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 24 Oct 1979 (45 years ago)
Entity Number: 000-059-597
Register Number: 000059597
Historical Names: Michael Alan Grossman, M.D., P.C.
Valley Heart & Lung Clinic, P.C.
Place of Formation: Chambers County
Principal Address: LANGDALE, AL
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities INTERNAL MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1164621223 2007-07-17 2009-01-26 21 MEDICAL PARK, VALLEY, AL, 368543665, US 21 MEDICAL PARK, VALLEY, AL, 368543665, US

Contacts

Phone +1 334-756-4156
Fax 3347568181

Authorized person

Name MITCHEL L GALISHOFF
Role BUSINESS OWNER
Phone 3347564156

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
License Number 17338
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 529202520
State AL
Issuer MEDICAID
Number 000594382A
State GA

Incorporator

Name Role
GROSSMAN, MICHAEL ALAN Incorporator
GROSSMAN, CECILIA T Incorporator
BONNER, KATHY Incorporator

Events

Event Date Event Type Old Value New Value
1994-04-11 Name Change Valley Heart & Lung Clinic, P.C. Valley Medical & Surgical Clinic, P.C.
1992-03-02 Name Change Michael Alan Grossman, M.D., P.C. Valley Heart & Lung Clinic, P.C.

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State