MEDICARE: ALY E ALY 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	207RN0300X	Nephrology Physician	19742	OK

General Provider Information

NPI Number	:	1316940117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALY E ALY MD

Provider Business Mailing Address
First Line	:	3366 NW EXPRESSWAY BLDG D
Second Line	:	SUITE 730
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4462
Country	:	US
Telephone Number	:	405-951-4944
Fax Number	:	405-951-4955

Provider Business Practice Location Address
First Line	:	3366 NW EXPRESSWAY BLDG D
Second Line	:	SUITE 730
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4462
Country	:	US
Telephone Number	:	405-951-4944
Fax Number	:	405-951-4955

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/02/2007

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Directions to “ ALY E ALY MD” Practice Location

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