Healthcare Provider Details

I. General information

NPI: 1831284769
Provider Name (Legal Business Name): SYED ASIF H ALI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11219 LOCKWOOD DR
SILVER SPRING MD
20901-4550
US

IV. Provider business mailing address

11219 LOCKWOOD DR
SILVER SPRING MD
20901-4550
US

V. Phone/Fax

Practice location:
  • Phone: 301-557-9638
  • Fax:
Mailing address:
  • Phone: 301-557-9638
  • Fax: 301-557-9642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberD0063945
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberD0063945
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0063945
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0063945
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: