Healthcare Provider Details

I. General information

NPI: 1104736669
Provider Name (Legal Business Name): NAJAH MOHAMED ALI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2928 CURRY PKWY APT 18
MADISON WI
53713-2877
US

IV. Provider business mailing address

PO BOX 44562
MADISON WI
53744-4562
US

V. Phone/Fax

Practice location:
  • Phone: 404-421-1008
  • Fax:
Mailing address:
  • Phone: 404-421-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: