Provider Demographics
NPI:1609001536
Name:MEK MEDICAL STAFFING & SERVICES INC
Entity Type:Organization
Organization Name:MEK MEDICAL STAFFING & SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-552-5696
Mailing Address - Street 1:13339 MOONLIGHT TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-6700
Mailing Address - Country:US
Mailing Address - Phone:443-964-5950
Mailing Address - Fax:
Practice Address - Street 1:11890 HEALING WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7917
Practice Address - Country:US
Practice Address - Phone:443-964-5950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MED0064866207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC061523800Medicaid
MD92199401OtherBLUE CROSS BLUE SHIELD
DCU4560001OtherBLUE CROSS BLUE SHIELD
MD414132600Medicaid
DC061523800Medicaid