Healthcare Provider Details

I. General information

NPI: 1740115534
Provider Name (Legal Business Name): MOHAMMAD BURHAN ALI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 HILLIARD ROME RD
HILLIARD OH
43026-9471
US

IV. Provider business mailing address

7418 GARDENVIEW PL
DUBLIN OH
43016-8200
US

V. Phone/Fax

Practice location:
  • Phone: 614-771-4172
  • Fax: 614-771-4173
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03443655
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: