Provider Demographics
NPI:1306325816
Name:MUSLIM COMMUNITY OF KNOXVILLE'S SHIFA CLINIC
Entity type:Organization
Organization Name:MUSLIM COMMUNITY OF KNOXVILLE'S SHIFA CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SADRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-385-6232
Mailing Address - Street 1:1801 AILOR AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-5845
Mailing Address - Country:US
Mailing Address - Phone:865-851-9979
Mailing Address - Fax:865-851-9984
Practice Address - Street 1:1801 AILOR AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-5845
Practice Address - Country:US
Practice Address - Phone:865-851-9979
Practice Address - Fax:865-851-9984
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MUSLIM COMMUNITY OF KNOXVILLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-07
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty