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General NPI Number Information
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NPI Number | 1861135543
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Entity Type | Individual
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Provider Name | ALI DOURRA DPM
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Gender | Male
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Dates
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Enumeration Date | 04/19/2022
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 5300 HARROUN RD STE 201
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City | SYLVANIA
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State | OH
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Zip | 43560-2146
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Country | US
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Telephone | 419-885-5563
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Fax | 419-885-5439
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Provider Business Mailing Address
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Address Line | 5300 HARROUN RD STE 201
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City | SYLVANIA
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State | OH
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Zip | 43560-2146
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Country | US
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Telephone | 419-885-5563
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5951001469
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36.004206
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License Number State | OH
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