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NPI Code Detail

MEDICARE: MR. ISMAIL IBRAHIM ALI

MEDICARE:  MR. ISMAIL IBRAHIM 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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1891203287
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ISMAIL IBRAHIM ALI
Provider Business Mailing Address
First Line : 3601 E MCDOWELL RD
Second Line : APT 1020
City : PHOENIX
State : AZ
Zip : 85008
Country : US
Telephone Number : 602-459-5215
Fax Number :
Provider Business Practice Location Address
First Line : 3601 E MCDOWELL RD APT 1020
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4378
Country : US
Telephone Number : 602-459-5215
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2018
Last Update Date : 01/19/2018

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Directions to “ MR. ISMAIL IBRAHIM ALI ” Practice Location

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