Provider Demographics
NPI:1790768380
Name:UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.
Entity Type:Organization
Organization Name:UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER (UHC OF MID
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:215-832-4501
Mailing Address - Street 1:800 KING FARM
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5979
Mailing Address - Country:US
Mailing Address - Phone:703-462-7417
Mailing Address - Fax:703-286-3994
Practice Address - Street 1:800 KING FARM BLVD SUITE 800
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:571-455-4605
Practice Address - Fax:703-286-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA10153302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization