Healthcare Provider Details

I. General information

NPI: 1083956015
Provider Name (Legal Business Name): US MEDICAL & BUSINESS CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 S COLLEGE MALL RD STE 350
BLOOMINGTON IN
47401-6301
US

IV. Provider business mailing address

899 S COLLEGE MALL RD STE 350
BLOOMINGTON IN
47401-6301
US

V. Phone/Fax

Practice location:
  • Phone: 812-964-0964
  • Fax:
Mailing address:
  • Phone: 812-964-0964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MAHER ELSARRAG
Title or Position: VICE PRESIDENT
Credential:
Phone: 812-964-0964