Custom Family Care, LLC

NPI #1053839811 in Madison, Alabama

Provider Information

NPI Number: 1053839811
Entity Type: Organization
Organization Name: Custom Family Care, LLC
Primary Specialty: Family Medicine
Enumeration Date: Aug 31, 2017
Last Updated: Jun 2, 2021

Practice Location

Address: 279 HUGHES RD
City: Madison
State: Alabama
ZIP Code: 35758-1142
Phone: (256) 289-1733

Authorized Official

Name: IVAN PIVOVAROV, MD
Title: PRESIDENT
Phone: (256) 325-0480

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Urgent Care — Urgent Care	261QU0200X
Family Medicine	207Q00000X	Primary

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