Provider Demographics
NPI:1578928875
Name:UNITED MEDICAL GROUP
Entity Type:Organization
Organization Name:UNITED MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABDULKARIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUKDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-232-9800
Mailing Address - Street 1:22750 ROCKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1574
Mailing Address - Country:US
Mailing Address - Phone:440-232-9800
Mailing Address - Fax:440-226-8765
Practice Address - Street 1:22750 ROCKSIDE RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-1574
Practice Address - Country:US
Practice Address - Phone:440-232-9800
Practice Address - Fax:440-226-8765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36D210810291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory