Provider Demographics
NPI:1396401022
Name:MIU GROUP LLC
Entity Type:Organization
Organization Name:MIU GROUP LLC
Other - Org Name:MIU CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUNACHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:UYANWUNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-275-2068
Mailing Address - Street 1:57 W TIMONIUM RD STE 305
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3106
Mailing Address - Country:US
Mailing Address - Phone:443-275-2068
Mailing Address - Fax:833-907-2413
Practice Address - Street 1:57 W TIMONIUM RD STE 305
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3106
Practice Address - Country:US
Practice Address - Phone:860-573-8109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)