Provider Demographics
NPI:1063633600
Name:ALI, HUMAIRA RASHID (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMAIRA
Middle Name:RASHID
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 1:12698 WIMBLEY LANE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192
Mailing Address - Country:US
Mailing Address - Phone:703-680-5048
Mailing Address - Fax:
Practice Address - Street 1:SAINT ELIZABETHS HOSPITAL,2700 MLK AVE.
Practice Address - Street 2:
Practice Address - City:WASHINGTON .D.C.
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-645-7595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD17101207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E 13446Medicare UPIN