Provider Demographics
NPI:1972101350
Name:UBERPHYSICIANS LLC
Entity Type:Organization
Organization Name:UBERPHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ATEMKENG
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:FOMENGIA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:410-216-0206
Mailing Address - Street 1:2614 28TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:724 MAIDEN CHOICE LN STE 304
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5967
Practice Address - Country:US
Practice Address - Phone:410-216-0206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty