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General NPI Number Information
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NPI Number | 1427509413
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Entity Type | Organization
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Legal Business Name | UNITED MEDICAL PRACTICE LLC
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 4404 QUEENSBURY RD #100
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City | RIVERDALE
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State | MD
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Zip | 20737-1068
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Country | US
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Telephone | 301-779-1949
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Fax |
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Provider Business Mailing Address
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Address Line | 4404 QUEENSBURY RD #100
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City | RIVERDALE
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State | MD
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Zip | 20737-1068
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Country | US
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Telephone | 301-779-1949
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. NIGUSSIE ALEMU GELETA
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Credential | MD
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Telephone | 240-462-8884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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