Healthcare Provider Details

I. General information

NPI: 1265942403
Provider Name (Legal Business Name): UBYLEE HEALTHCARE GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9723 NORTHEAST PKWY STE 100
MATTHEWS NC
28105-9719
US

IV. Provider business mailing address

PO BOX 1707
MATTHEWS NC
28106-1707
US

V. Phone/Fax

Practice location:
  • Phone: 980-262-3007
  • Fax: 980-262-3528
Mailing address:
  • Phone: 800-984-7279
  • Fax: 980-262-3528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BAPTISTE STEVEN MARINO
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: MD
Phone: 800-984-7279