Provider Demographics
NPI:1558078113
Name:M D URGENT MEDICAL CARE LLC
Entity Type:Organization
Organization Name:M D URGENT MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-308-6496
Mailing Address - Street 1:1025 E 11400 S STE 103
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-6947
Mailing Address - Country:US
Mailing Address - Phone:912-308-6496
Mailing Address - Fax:
Practice Address - Street 1:1025 E 11400 S STE 103
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-6947
Practice Address - Country:US
Practice Address - Phone:912-308-6496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care