Healthcare Provider Details

I. General information

NPI: 1295806966
Provider Name (Legal Business Name): UNITED PHYSICIANS MEDICAL GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 S LINDEN RD SUITE F
FLINT MI
48532-3442
US

IV. Provider business mailing address

1303 S LINDEN RD SUITE F
FLINT MI
48532-3442
US

V. Phone/Fax

Practice location:
  • Phone: 810-230-0800
  • Fax: 810-230-0880
Mailing address:
  • Phone: 810-230-0800
  • Fax: 810-230-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301071799
License Number StateMI

VIII. Authorized Official

Name: KARIM I MOHAMED
Title or Position: OWNER PRESIDENT
Credential: MD
Phone: 810-230-0800