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General NPI Number Information
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NPI Number | 1780258624
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Entity Type | Individual
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Provider Name | ZAENAB MOHAMED BUSHAALA ALI MD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2021
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 413 S LOOP RD
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City | EDGEWOOD
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State | KY
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Zip | 41017-5446
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Country | US
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Telephone | 859-301-3800
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Fax | 859-301-3987
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Provider Business Mailing Address
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Address Line | PO BOX 636324
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City | CINCINNATI
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State | OH
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Zip | 45263-6324
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Country | US
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Telephone | 859-344-5555
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Fax | 859-344-5552
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 59313
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License Number State | KY
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