Healthcare Provider Details

I. General information

NPI: 1679583454
Provider Name (Legal Business Name): SYED S. ALI, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2032 WYNNTON RD SUITE B
COLUMBUS GA
31906-2448
US

IV. Provider business mailing address

2032 WYNNTON RD SUITE B
COLUMBUS GA
31906-2448
US

V. Phone/Fax

Practice location:
  • Phone: 706-320-9355
  • Fax:
Mailing address:
  • Phone: 706-320-9355
  • Fax: 706-324-7585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: SYED ALI
Title or Position: DR.
Credential: MD
Phone: 706-320-9355