Provider Demographics
NPI:1073811683
Name:ALI, IFTIKHAR (MD,)
Entity Type:Individual
Prefix:DR
First Name:IFTIKHAR
Middle Name:
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 1:29 KINGS BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-6411
Mailing Address - Country:US
Mailing Address - Phone:508-425-3545
Mailing Address - Fax:
Practice Address - Street 1:29 KINGS BROOK AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-6411
Practice Address - Country:US
Practice Address - Phone:508-425-3545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-06
Last Update Date:2011-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program