MEDICARE: IMAN ALI

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	2084P0800X	Psychiatry Physician	1366196552	MD

General Provider Information

NPI Number	:	1366196552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IMAN ALI

Provider Business Mailing Address
First Line	:	733 N BROADWAY STE 147
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21205-1832
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N WOLFE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21287-0005
Country	:	US
Telephone Number	:	410-955-5000
Fax Number	:

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

Provider Enumeration Date	:	02/07/2022
Last Update Date	:	06/10/2026

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Directions to “ IMAN ALI ” Practice Location

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