Organization
BEACH MIDWAY MED EXPRESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATA ULHAQ MD (PHYSICIAN)
(850) 588-5778
Entity
Organization
Contact information
Practice address
11038 HUTCHISON BLVD, PANAMA CITY, FL 32407
(850) 588-5778
(850) 588-5718
Mailing address
8526 SOUTH AVE, POLAND, OH 44514-3620
(330) 758-2775
(330) 758-2787
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/23/2018
Last updated
07/10/2018
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