Healthcare Provider Details

I. General information

NPI: 1568154201
Provider Name (Legal Business Name): ALI HEALTH PRIMARY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28653 HOOVER RD
WARREN MI
48093-4105
US

IV. Provider business mailing address

28653 HOOVER RD
WARREN MI
48093-4105
US

V. Phone/Fax

Practice location:
  • Phone: 313-413-3709
  • Fax:
Mailing address:
  • Phone: 313-413-3709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TARIK ALI
Title or Position: OWNER
Credential: DO
Phone: 734-788-9466