Basic Information
| Provider Information | |||||||||
| NPI: | 1467615039 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY MEDICAL ASSOCIATES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 PARKS HALL | ||||||||
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| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405932542 | ||||||||
| FaxNumber: | 7405930626 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 HOSPITAL DR | ||||||||
| Address2: | SUITE 370 | ||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457012857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405664530 | ||||||||
| FaxNumber: | 7405664535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2008 | ||||||||
| LastUpdateDate: | 06/28/2011 | ||||||||
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| AuthorizedOfficialLastName: | DAVIES | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7405932267 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0101X | 34003705 | OH | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology |
No ID Information.