Provider Demographics
NPI:1982057626
Name:UMG URGENT CARE OF MARYLAND LLC
Entity type:Organization
Organization Name:UMG URGENT CARE OF MARYLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HERISCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-812-0949
Mailing Address - Street 1:7201 WISCONSIN AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4810
Mailing Address - Country:US
Mailing Address - Phone:202-812-0949
Mailing Address - Fax:
Practice Address - Street 1:13671 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5214
Practice Address - Country:US
Practice Address - Phone:240-219-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0071488261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care