Healthcare Provider Details
I. General information
NPI: 1396046108
Provider Name (Legal Business Name): UNITED MEDICAL CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/10/2010
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
121 BECKS WOODS DR STE 100
BEAR DE
19701-3853
US
IV. Provider business mailing address
161 BECKS WOODS DR
BEAR DE
19701-3833
US
V. Phone/Fax
- Phone: 302-261-5600
- Fax: 302-836-4302
- Phone: 302-266-9166
- Fax: 866-670-8036
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEMAL
ERKAN
Title or Position: OWNER
Credential: FACHE
Phone: 302-451-5600