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General NPI Number Information
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NPI Number | 1720507742
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Entity Type | Organization
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Legal Business Name | RELIANCE WALK IN MEDICAL, LLC
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 09/21/2017
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Provider Practice Location Address
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Address Line | 131 BECKS WOODS DR
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City | BEAR
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State | DE
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Zip | 19701-3833
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Country | US
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Telephone | 667-215-0159
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | BEAR
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State | DE
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Zip | 19701-0188
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Country | US
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Telephone | 667-215-0159
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | QAYYUM NAZAR
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Credential | MD
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Telephone | 667-215-0159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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