Healthcare Provider Details

I. General information

NPI: 1619975026
Provider Name (Legal Business Name): ALI R HOMAYUNI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2005
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 ABERCORN ST
SAVANNAH GA
31405-5701
US

IV. Provider business mailing address

6301 ABERCORN ST
SAVANNAH GA
31405-5701
US

V. Phone/Fax

Practice location:
  • Phone: 917-287-2974
  • Fax: 917-287-2974
Mailing address:
  • Phone: 917-287-2974
  • Fax: 800-618-6657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number51391
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number20188
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number20188
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: