Organization
UNITED PHYSICIANC CARE INC
Active
Other names
Oakland Family Medicine Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J CARUSO (EXECUTIVE DIRECTOR)
(304) 624-4655
Entity
Organization
Contact information
Practice address
1533 MEMORIAL DR, OAKLAND, MD 21550-4338
(301) 334-3400
(301) 334-5977
Mailing address
686 S PIKE ST, STE A, SHINNSTON, WV 26431-1043
(304) 624-4655
(304) 624-3918
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6705017000
—
WV
Enumeration date
12/01/2006
Last updated
01/03/2008
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