Provider Demographics
NPI:1255387866
Name:UNITED MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:UNITED MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRATIP
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-287-7800
Mailing Address - Street 1:5701 STATE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-1236
Mailing Address - Country:US
Mailing Address - Phone:913-287-7800
Mailing Address - Fax:
Practice Address - Street 1:5701 STATE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1236
Practice Address - Country:US
Practice Address - Phone:913-287-7800
Practice Address - Fax:913-287-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS24587019OtherBCBS KANSAS CITY GROUP #
KS110393OtherBCBS KANSAS GROUP#
KSCN2491Medicare ID - Type UnspecifiedRAILROAD MC GROUP#
KSH950000Medicare ID - Type UnspecifiedGROUP NUMBER
KS24587019OtherBCBS KANSAS CITY GROUP #