Provider Demographics
NPI:1003828724
Name:ALI, UZMA M (MD)
Entity Type:Individual
Prefix:DR
First Name:UZMA
Middle Name:M
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 PELHAM DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-2725
Mailing Address - Country:US
Mailing Address - Phone:540-283-9039
Mailing Address - Fax:540-324-4164
Practice Address - Street 1:2133 PELHAM DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-2725
Practice Address - Country:US
Practice Address - Phone:540-283-9039
Practice Address - Fax:540-324-4164
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238234207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010309191Medicaid
VAP00331756OtherMEDICARE RAILROAD
VA010309191Medicaid
I34609Medicare UPIN