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NPI Code Detail

MEDICARE: SHEHARYAR ALI MD

MEDICARE: SHEHARYAR 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
1207RC0000XCardiovascular Disease PhysicianE6059AR
2207R00000XInternal Medicine Physician33912IA
3207RI0011XInterventional Cardiology Physician69380AZ
4207RI0011XInterventional Cardiology PhysicianE-6059AR

General Provider Information

NPI Number : 1427099712
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEHARYAR ALI MD
Provider Business Mailing Address
First Line : 2205 W MAIN ST
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72801-2759
Country : US
Telephone Number : 479-968-4311
Fax Number : 479-968-4399
Provider Business Practice Location Address
First Line : 2205 W MAIN ST
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72801-2759
Country : US
Telephone Number : 479-968-4311
Fax Number : 479-968-4399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 05/23/2023

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Directions to “ SHEHARYAR ALI MD” Practice Location

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