Healthcare Provider Details

I. General information

NPI: 1679278063
Provider Name (Legal Business Name): UNITED CARE TEAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10440 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3648
US

IV. Provider business mailing address

PO BOX 5694
CAROL STREAM IL
60197-5694
US

V. Phone/Fax

Practice location:
  • Phone: 888-402-0202
  • Fax: 888-860-2960
Mailing address:
  • Phone: 888-402-0202
  • Fax: 888-860-2960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY MILLER
Title or Position: DIRECTOR OF RCM
Credential:
Phone: 248-331-7908