Provider Demographics
NPI:1871036020
Name:MEDICAL CIRCLE OF AMERICA PLLC
Entity Type:Organization
Organization Name:MEDICAL CIRCLE OF AMERICA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAYTHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:774-633-6793
Mailing Address - Street 1:59 N QUINSIGAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-5143
Mailing Address - Country:US
Mailing Address - Phone:774-633-6793
Mailing Address - Fax:888-976-3637
Practice Address - Street 1:59 N QUINSIGAMOND AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-5143
Practice Address - Country:US
Practice Address - Phone:774-633-6793
Practice Address - Fax:888-976-3637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224372207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty