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1275559072

NPI Code Detail

MEDICARE: DR. MIR T ALI M.D.

MEDICARE: DR. MIR T ALI M.D.

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	0101237755	VA
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	0101237755	VA
3	207RP1001X	Pulmonary Disease Physician	0101237755	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00241104	OTHER	VA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180697	OTHER	VA	HEALTHKEEPERS
2	227986794	OTHER	VA	TRICARE
3	309313	OTHER	VA	SOUTHERN HEALTH
4	56636	OTHER	VA	CARENET
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	7814656	OTHER	VA	AETNA
8	2788714	OTHER	VA	CIGNA
9	180697	OTHER	VA	ANTHEM
10	3768258	OTHER	VA	AETNA HMO

General Provider Information

NPI Number	:	1275559072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIR T ALI M.D.

Provider Business Mailing Address
First Line	:	1000 BOULDERS PKWY
Second Line	:	SUITE 102
City	:	RICHMOND
State	:	VA
Zip	:	23225-5545
Country	:	US
Telephone Number	:	804-320-4243
Fax Number	:	804-622-0552

Provider Business Practice Location Address
First Line	:	6600 W BROAD ST STE 300
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-1709
Country	:	US
Telephone Number	:	804-320-4243
Fax Number	:	804-622-0552

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	02/20/2026

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Directions to “ DR. MIR T ALI M.D.” Practice Location

Language	Start Address	Practice Location

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