Healthcare Provider Details

I. General information

NPI: 1760853931
Provider Name (Legal Business Name): UNITED MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22750 ROCKSIDE RD
BEDFORD OH
44146-1574
US

IV. Provider business mailing address

PO BOX 5534
CAROL STREAM IL
60197-5534
US

V. Phone/Fax

Practice location:
  • Phone: 440-232-9800
  • Fax: 440-226-8765
Mailing address:
  • Phone: 216-472-2730
  • Fax: 216-472-2740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABDULKARIM MOUKDAD
Title or Position: CEO
Credential:
Phone: 440-232-9800