Provider Demographics
NPI:1861646952
Name:MEDICLINIK
Entity Type:Organization
Organization Name:MEDICLINIK
Other - Org Name:MEDITRAVELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:B
Authorized Official - Last Name:NAWAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-207-6770
Mailing Address - Street 1:14173 MANCHESTER RD STE C
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4524
Mailing Address - Country:US
Mailing Address - Phone:877-207-6770
Mailing Address - Fax:
Practice Address - Street 1:14173 MANCHESTER RD STE C
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-4524
Practice Address - Country:US
Practice Address - Phone:877-207-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-16
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty