MEDICARE: DR. ABDALLA ABDALLA-ALI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	4301065971	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	203742	OTHER	MI	MCLAREN HEALTH PLAN
2	203742	OTHER	MI	HEALTH ADVANTAGE NETWORK
3	5517663	OTHER	MI	AETNA
4	330485	OTHER	MI	BLUE CROSS BLUE SHIELD
5	1200183	OTHER	MI	PHYSICIANS HEALTH PLAN
6	350D410030	OTHER	MI	COMMUNITY BLUE PPO
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	350D410030	OTHER	MI	BLUE CHOICE
9	350C361520	OTHER	MI	BLUE CROSS BLUE SHIELD
10	350D410030	OTHER	MI	BLUE CARE NETWORK
11	350D410030	OTHER	MI	BLUE CROSS BLUE SHIELD
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	G87637	OTHER	MI	HEALTH NET FED SERVICES

General Provider Information

NPI Number	:	1134101074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDALLA ABDALLA-ALI MD

Provider Business Mailing Address
First Line	:	804 SERVICE RD STE A109B
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48824-7015
Country	:	US
Telephone Number	:	517-364-5440
Fax Number	:	517-364-5409

Provider Business Practice Location Address
First Line	:	1200 E MICHIGAN AVE STE 145
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-1897
Country	:	US
Telephone Number	:	517-364-5440
Fax Number	:	517-364-5409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	09/25/2023

Similar Medicare Providers

1902733314 — NATALIE DELEMEESTER MD
Practice Location Address:

1200 E MICHIGAN AVE STE 245
LANSING, MI
48912-1897

Practice Phone: 517-364-5710
Practice Fax:

1033111653 — HARRIETTA CHRISTODOULOS DO
Practice Location Address:

1200 E MICHIGAN AVE STE 145
LANSING, MI
48912-1897

Practice Phone: 517-364-5440
Practice Fax: 517-364-5409

1700832987 — MRS. KELLIE MARIE WELLS PA
Practice Location Address:

1200 E MICHIGAN AVE STE 415
LANSING, MI
48912-1897

Practice Phone: 517-484-2760
Practice Fax: 517-484-9370

1518978345 — OLGA I NAPOLOVA MD
Practice Location Address:

1200 E MICHIGAN AVE STE 145
LANSING, MI
48912-1897

Practice Phone: 517-364-5440
Practice Fax: 517-364-5409

1568564813 — DR. MARIA JEVITZ PATTERSON M.D.
Practice Location Address:

1200 E MICHIGAN AVE STE 145
LANSING, MI
48912-1897

Practice Phone: 517-364-5440
Practice Fax: 517-364-5409

1770687998 — DR. RANDOLPH LESTER PEARSON M.D.
Practice Location Address:

1200 E MICHIGAN AVE STE 245
LANSING, MI
48912-1897

Practice Phone: 517-364-5710
Practice Fax: 517-364-5718

Directions to “ DR. ABDALLA ABDALLA-ALI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.