Provider Demographics
NPI:1447662663
Name:MEDSTAR URGENT CARE, LLC
Entity type:Organization
Organization Name:MEDSTAR URGENT CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-933-2260
Mailing Address - Street 1:8094 SANDPIPER CIR
Mailing Address - Street 2:SUITE O
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4907
Mailing Address - Country:US
Mailing Address - Phone:410-933-2260
Mailing Address - Fax:410-933-3077
Practice Address - Street 1:1420 KEY HWY STE 200
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5116
Practice Address - Country:US
Practice Address - Phone:410-230-7820
Practice Address - Fax:410-230-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care