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NPI Code Detail

MEDICARE: WELLNESS MEDICAL CLINIC LLC

MEDICARE: WELLNESS MEDICAL CLINIC LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1173000000XLegal Medicine35-082017OH

General Provider Information

NPI Number : 1841735909
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLNESS MEDICAL CLINIC LLC
Provider Business Mailing Address
First Line : 3033 SULLIVANT AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-2424
Country : US
Telephone Number : 614-670-7771
Fax Number : 614-385-7771
Provider Business Practice Location Address
First Line : 3033 SULLIVANT AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-2424
Country : US
Telephone Number : 614-670-7771
Fax Number : 614-385-7771
Authorized Official
Title or Position : OWNER
Name : MUHAMMAD ASHRAF
Credential : M.D.
Telephone Number : 614-670-7771
Provider Enumeration Date : 12/28/2016
Last Update Date : 12/28/2016

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Directions to “WELLNESS MEDICAL CLINIC LLC ” Practice Location

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