Provider Demographics
NPI:1427509413
Name:UNITED MEDICAL PRACTICE LLC
Entity type:Organization
Organization Name:UNITED MEDICAL PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIGUSSIE
Authorized Official - Middle Name:ALEMU
Authorized Official - Last Name:GELETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-462-8884
Mailing Address - Street 1:4404 QUEENSBURY RD
Mailing Address - Street 2:#100
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1068
Mailing Address - Country:US
Mailing Address - Phone:301-779-1949
Mailing Address - Fax:
Practice Address - Street 1:4404 QUEENSBURY RD
Practice Address - Street 2:#100
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1068
Practice Address - Country:US
Practice Address - Phone:301-779-1949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty