Provider Demographics
NPI:1558161414
Name:MD GENETIC LLC
Entity type:Organization
Organization Name:MD GENETIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ MEDICAL GENETICIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FALAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-701-3613
Mailing Address - Street 1:1943 PLEASANT MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-0528
Mailing Address - Country:US
Mailing Address - Phone:317-701-3613
Mailing Address - Fax:941-279-3154
Practice Address - Street 1:1201 6TH AVE W STE 100-668
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-7400
Practice Address - Country:US
Practice Address - Phone:941-202-2260
Practice Address - Fax:941-279-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center