Healthcare Provider Details

I. General information

NPI: 1356891030
Provider Name (Legal Business Name): URUK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 SOUTHERN AVE SE
WASHINGTON DC
20032-4623
US

IV. Provider business mailing address

100 1ST ST #333
ROCKVILLE MD
20851-1314
US

V. Phone/Fax

Practice location:
  • Phone: 301-275-1348
  • Fax:
Mailing address:
  • Phone: 301-275-1348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD035768
License Number StateDC

VIII. Authorized Official

Name: LEITH A ABDULLA
Title or Position: SOLE MEMBER
Credential: M.D.
Phone: 301-275-1348