MEDICARE: ALI SEYED NABAVI DO

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	OS018526	PA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	86795	GA
3	207R00000X	Internal Medicine Physician	25MB10332800	NJ
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	99102569A	IN
5	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	83526	SC
6	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	25MB10332800	NJ

General Provider Information

NPI Number	:	1891131652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI SEYED NABAVI DO

Provider Business Mailing Address
First Line	:	2450 W HUNTING PARK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19129-1302
Country	:	US
Telephone Number	:	215-926-9022
Fax Number	:	215-226-8286

Provider Business Practice Location Address
First Line	:	300 E MCBEE AVE FL 4
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:	864-522-8603
Fax Number	:

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

Provider Enumeration Date	:	05/20/2013
Last Update Date	:	06/03/2024

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Directions to “ ALI SEYED NABAVI DO” Practice Location

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