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General NPI Number Information
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NPI Number | 1306325816
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Entity Type | Organization
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Legal Business Name | MUSLIM COMMUNITY OF KNOXVILLE'S SHIFA CLINIC
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 1801 AILOR AVE
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City | KNOXVILLE
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State | TN
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Zip | 37921-5845
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Country | US
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Telephone | 865-851-9979
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Fax | 865-851-9984
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Provider Business Mailing Address
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Address Line | 1801 AILOR AVE
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City | KNOXVILLE
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State | TN
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Zip | 37921-5845
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Country | US
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Telephone | 865-851-9979
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Fax | 865-851-9984
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | SADRIL MOHAMMAD
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Credential |
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Telephone | 865-385-6232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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