Provider Demographics
NPI:1033350392
Name:ALI, MOHAMMAD YALMAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:YALMAZ
Last Name:ALI
Suffix:
Gender:M
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:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-247-4240
Mailing Address - Fax:515-247-4239
Practice Address - Street 1:100 NORTH ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-1341
Practice Address - Country:US
Practice Address - Phone:570-271-6408
Practice Address - Fax:570-271-5845
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA40317207R00000X
LAMD.203057207R00000X
IAMD-40317207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1809799Medicaid
LA4M452Medicare PIN