Healthcare Provider Details

I. General information

NPI: 1275828063
Provider Name (Legal Business Name): ALI Y SULIMAN MD, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 DANNY THOMAS PL # MS 310
MEMPHIS TN
38105-3678
US

IV. Provider business mailing address

262 DANNY THOMAS PL # MS 1130
MEMPHIS TN
38105-3678
US

V. Phone/Fax

Practice location:
  • Phone: 901-595-3300
  • Fax: 901-595-7944
Mailing address:
  • Phone: 203-595-2740
  • Fax: 203-737-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number56638
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: