Provider Demographics
NPI:1952659666
Name:INTEGRATED MEDICAL CARE
Entity Type:Organization
Organization Name:INTEGRATED MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WEI
Authorized Official - Middle Name:
Authorized Official - Last Name:CUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-648-0025
Mailing Address - Street 1:9800 GLYNSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854
Mailing Address - Country:US
Mailing Address - Phone:443-980-0031
Mailing Address - Fax:301-424-2680
Practice Address - Street 1:11119 ROCKVILLE PIKE STE 406
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3143
Practice Address - Country:US
Practice Address - Phone:301-648-0025
Practice Address - Fax:301-424-2680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD68315261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care