Organization Active NPI

Beach Midway Med Express

  • Internal Medicine Physician
  • Panama City, FL
National Provider Identifier
1235637497
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BEACH MIDWAY MED EXPRESS
Practice address
11038 Hutchison Blvd
Panama City, FL 32407
Phone
(850) 588-5778
Fax
(850) 588-5718
NPI assigned
Jan 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ata Ulhaq, MD
Title
Physician
Phone
(850) 588-5778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

11038 Hutchison Blvd
Panama City, FL 32407

Mailing address

8526 South Ave
Poland, OH 44514-3620
Phone (330) 758-2775

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2143746Beach Midway Med Express11038 Hutchison Blvd, Panama City Beach, FL 32407Certificate of waiverFeb 4, 2028

National Provider Directory

National Provider Directory

Locations

8526 South Ave
Youngstown, OH 44514

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1235637497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8526 SOUTH AVE",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143620",
            "telephone_number": "330-758-2775",
            "fax_number": "330-758-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11038 HUTCHISON BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "32407",
            "telephone_number": "850-588-5778",
            "fax_number": "850-588-5718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH MIDWAY MED EXPRESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "ULHAQ",
        "authorized_official_first_name": "ATA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "850-588-5778",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.