Healthcare Provider Details

I. General information

NPI: 1396307724
Provider Name (Legal Business Name): ABDULLA M SHEREEF ALI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3186 S MARYLAND PKWY
LAS VEGAS NV
89109-2317
US

IV. Provider business mailing address

10257 HOWLING WIND ST
LAS VEGAS NV
89141-9075
US

V. Phone/Fax

Practice location:
  • Phone: 347-845-2247
  • Fax:
Mailing address:
  • Phone: 347-845-2247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number25202
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: