Basic Information
| Provider Information | |||||||||
| NPI: | 1356891030 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | URUK LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 1ST ST | ||||||||
| Address2: | #333 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208511314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012751348 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1310 SOUTHERN AVE SE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200324623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012751348 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2016 | ||||||||
| LastUpdateDate: | 10/06/2016 | ||||||||
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| AuthorizedOfficialLastName: | ABDULLA | ||||||||
| AuthorizedOfficialFirstName: | LEITH | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 3012751348 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MD035768 | DC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | MD035768 | 01 | DC | DEPARTMENT OF HEALTH | OTHER |