Individual provider · NPI-1

Qais Abu Ali, M.D.

Internal Medicine · Canton, OH

NPI number1033370473
StatusActive
Last updated in NPPESMay 14, 2012

Details

NPI
1033370473
Entity type
Individual (NPI-1)
Name
Qais Abu Ali
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 18, 2008
Last updated
May 14, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine40491AZYes
390200000X Student in an Organized Health Care Education/Training Program4301079654MI
170100000X Medical Genetics, Ph.D. Medical Genetics40491AZ

Practice location

4506 Stephens Cir Nw
Canton, OH 44718-3628

Phone 330-994-0436 · Fax 330-492-4906

Mailing address

4506 Stephens Cir Nw
Canton, OH 44718-3628

Phone 330-994-0436 · Fax 330-492-4906

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