Provider Demographics
NPI:1689163651
Name:URUQ INCORPORATED
Entity Type:Organization
Organization Name:URUQ INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABDULLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-275-1348
Mailing Address - Street 1:100 1ST ST APT 333
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1350
Mailing Address - Country:US
Mailing Address - Phone:301-275-1358
Mailing Address - Fax:
Practice Address - Street 1:3411 OLANDWOOD CT STE 105
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1488
Practice Address - Country:US
Practice Address - Phone:301-774-5260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-06
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0080646207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0080646OtherMD DHMH LICENSE