Organization
UMBRELLA MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY A BAUGH (ADMINISTRATOR)
(719) 660-2696
Entity
Organization
Contact information
Practice address
3955 156TH ST NE, MARYSVILLE, WA 98271-4831
(719) 660-2696
Mailing address
1951 E AKHOLT LN, PUEBLO WEST, CO 81007-1291
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BUSINESS LICENSE
—
Enumeration date
05/13/2020
Last updated
05/13/2020
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