Completed AddVal application or CAQH login
       and password.

Curriculum Vitae MUST include month/year and
       all employment.

Medical License(s), DEA and State Controlled        Substances (CDS) Certificates;

Board Certificate(s).

Professional Liability Insurance page.

Documents regarding all settled, dismissed and
       (or) pending mal practice claims.

NPI Letter, number, login and password.

Copy of social security card, medical school diploma        and other training diplomas.

CME certificates; and letters for all current hospital        privileges.

Group information including: IRS letter, Tax ID,
       voided check, address, phone, fax, billing
       information and NPI letter, login and password.

 


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