Healthcare Provider Details

I. General information

NPI: 1881156891
Provider Name (Legal Business Name): ALI ABDULKAREEM ABBAS ALSARAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 E HARMONY RD STE 110
FORT COLLINS CO
80528-8623
US

IV. Provider business mailing address

2315 E HARMONY RD STE 110
FORT COLLINS CO
80528-8623
US

V. Phone/Fax

Practice location:
  • Phone: 970-482-7373
  • Fax: 970-484-5682
Mailing address:
  • Phone: 970-482-7373
  • Fax: 970-484-5682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2025027547
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number2025027547
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberCDRH.0076546
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: