Provider Demographics
NPI:1952128308
Name:CLINIBOOTH INC
Entity type:Organization
Organization Name:CLINIBOOTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SALUJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-581-8921
Mailing Address - Street 1:9705 MANOR OAKS VW
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3195
Mailing Address - Country:US
Mailing Address - Phone:937-581-8921
Mailing Address - Fax:
Practice Address - Street 1:9705 MANOR OAKS VW
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3195
Practice Address - Country:US
Practice Address - Phone:937-581-8921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care