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General NPI Number Information
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NPI Number | 1518697341
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Entity Type | Organization
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Legal Business Name | UNITED PROVIDERS OF HEALTH
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 108 E ANDREWS ST
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City | BETHEL
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State | NC
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Zip | 27812-7100
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Country | US
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Telephone | 919-701-6603
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Fax |
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Provider Business Mailing Address
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Address Line | 9650 STRICKLAND RD # 103-189
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City | RALEIGH
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State | NC
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Zip | 27615-1902
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Country | US
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Telephone | 919-701-6603
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | CAROLYN MAYO
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Credential |
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Telephone | 919-400-0718
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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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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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