Healthcare Provider Details
I. General information
NPI: 1346619004
Provider Name (Legal Business Name): UNITED MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2015
Last Update Date: 09/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
161 BECKS WOODS DR
BEAR DE
19701-3833
US
IV. Provider business mailing address
161 BECKS WOODS DR
BEAR DE
19701-3833
US
V. Phone/Fax
- Phone: 302-451-5600
- Fax: 866-319-6725
- Phone: 302-451-5600
- Fax: 866-319-6725
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | C1-0009802 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | C1-0003127 |
| License Number State | DE |
VIII. Authorized Official
Name: MR.
KEMAL
ERKAN
Title or Position: CHAIRMAN/ CEO
Credential:
Phone: 302-451-5600