Healthcare Provider Details

I. General information

NPI: 1407167612
Provider Name (Legal Business Name): FAISAL AL-ALIM M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 02/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2597 SCHOENERSVILLE RD STE 100
BETHLEHEM PA
18017-7325
US

IV. Provider business mailing address

PO BOX 783311
PHILADELPHIA PA
19178-3311
US

V. Phone/Fax

Practice location:
  • Phone: 484-884-5580
  • Fax: 484-884-5594
Mailing address:
  • Phone: 484-884-4500
  • Fax: 484-884-0699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberMD449919
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: