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General NPI Number Information
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NPI Number | 1811540800
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Entity Type | Individual
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Provider Name | MOHAMMED ALI MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 1031 E KARSCH BLVD
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City | FARMINGTON
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State | MO
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Zip | 63640-3404
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Country | US
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Telephone | 313-784-0429
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Fax |
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Provider Business Mailing Address
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Address Line | 1028 WABASH AVE APT 75
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City | FARMINGTON
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State | MO
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Zip | 63640-3425
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Country | US
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Telephone | 313-784-0429
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD482893
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 33449
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01090854A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.146528
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License Number State | OH
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