Provider Demographics
NPI:1558199414
Name:DOCTOR UNITED GROUP INC
Entity type:Organization
Organization Name:DOCTOR UNITED GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEGAL AND REGULATORY
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYHOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-819-1279
Mailing Address - Street 1:2150 W 76TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1884
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 PALM PLZ STE C
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6046
Practice Address - Country:US
Practice Address - Phone:877-384-6337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty