Provider Demographics
NPI:1487986360
Name:AMERICAN MEDICAL CLINIC INC
Entity type:Organization
Organization Name:AMERICAN MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-957-4484
Mailing Address - Street 1:1805 136TH PL NE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2331
Mailing Address - Country:US
Mailing Address - Phone:425-957-4484
Mailing Address - Fax:425-957-4575
Practice Address - Street 1:1805 136TH PL NE
Practice Address - Street 2:SUITE 103
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2331
Practice Address - Country:US
Practice Address - Phone:425-957-4484
Practice Address - Fax:425-957-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030967261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center