University Medical Group, Inc | |
50 Maude St Providence RI 02908-4325 | |
(401) 456-5368 | |
Not Available |
Full Name | University Medical Group, Inc |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 50 Maude St, Providence, Rhode Island |
Authorized Official Name and Position | Tracy Wallace (CEO) |
Authorized Official Contact | 4014562717 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
University Medical Group, Inc 825 Chalkstone Ave Providence RI 02908-4728 Ph: (401) 456-2717 | University Medical Group, Inc 50 Maude St Providence RI 02908-4325 Ph: (401) 456-5368 |
NPI Number | 1255367942 |
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Provider Enumeration Date | 06/24/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255367942 | NPI | - | NPPES |
UM 24173 | Medicaid | RI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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