Healthcare Provider Details

I. General information

NPI: 1366135162
Provider Name (Legal Business Name): MAHARISHI INTERNATIONAL UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N 4TH ST STE 143
FAIRFIELD IA
52556-2169
US

IV. Provider business mailing address

1100 N 4TH ST STE 143
FAIRFIELD IA
52556-2169
US

V. Phone/Fax

Practice location:
  • Phone: 641-472-1270
  • Fax: 641-472-1285
Mailing address:
  • Phone: 641-472-1270
  • Fax: 641-472-1285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAWAHAR SUNDARAM
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 641-472-1270