Provider Demographics
NPI:1114240868
Name:UNITED MED INC
Entity Type:Organization
Organization Name:UNITED MED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLILAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-353-1208
Mailing Address - Street 1:4950 BRAMBLETON AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4119
Mailing Address - Country:US
Mailing Address - Phone:540-353-1208
Mailing Address - Fax:866-614-2423
Practice Address - Street 1:4950 BRAMBLETON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4119
Practice Address - Country:US
Practice Address - Phone:540-353-1208
Practice Address - Fax:866-614-2423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101025788208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty