MEDICARE: MRS. BUSHRA K 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	207R00000X	Internal Medicine Physician	35093947	OH
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	35093947	OH
3	208M00000X	Hospitalist Physician	35093947	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00874900	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3227246	OTHER	OH	UNITED HEALTH CARE
4	9096404	OTHER	OH	AETNA
5	000000676687	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1861668402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BUSHRA K ALI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 8440
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-0440
Country	:	US
Telephone Number	:	419-725-2527
Fax Number	:	419-725-2528

Provider Business Practice Location Address
First Line	:	4895 MONROE ST STE 203
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-4349
Country	:	US
Telephone Number	:	419-725-2527
Fax Number	:	419-725-2528

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

Provider Enumeration Date	:	05/04/2008
Last Update Date	:	02/29/2024

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Directions to “ MRS. BUSHRA K ALI M.D.” Practice Location

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