Individual provider · NPI-1

Mohammed Ali, MD

Internal Medicine · Farmington, MO

NPI number1811540800
StatusActive
Last updated in NPPESFeb 6, 2024

Details

NPI
1811540800
Entity type
Individual (NPI-1)
Name
Mohammed Ali
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 19, 2019
Certification date
Feb 6, 2024
Last updated
Feb 6, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine35.146528OHYes
207R00000X Internal MedicineMD482893PA
207R00000X Internal Medicine33449WV
207R00000X Internal Medicine01090854AIN

Practice location

1031 E Karsch Blvd
Farmington, MO 63640-3404

Phone 313-784-0429

Mailing address

1028 Wabash Ave Apt 75
Farmington, MO 63640-3425

Phone 313-784-0429

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