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General NPI Number Information
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NPI Number | 1093885535
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Entity Type | Organization
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Legal Business Name | ADVANCED URGENT MEDICAL CARE, INC.
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/16/2009
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Provider Practice Location Address
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Address Line | 6020 RICHMOND HIGHWAY SUITE 100
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City | ALEXANDRIA
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State | VA
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Zip | 22303
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Country | US
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Telephone | 703-329-1037
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Fax | 703-329-4595
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Provider Business Mailing Address
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Address Line | 6020 RICHMOND HIGHWAY SUITE 100
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City | ALEXANDRIA
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State | VA
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Zip | 22303
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Country | US
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Telephone | 703-329-1037
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Fax | 703-329-4595
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Authorized Official
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Title or Position | PRESIDENT
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Name | LESLIE R PICKENS
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Credential | MD
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Telephone | 703-329-1037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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