Provider Demographics
NPI:1083800965
Name:ALI, MIR-OMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MIR-OMAR
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 1:8878 US 70 HWY W STE 400A
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-4824
Mailing Address - Country:US
Mailing Address - Phone:919-550-5663
Mailing Address - Fax:919-550-5761
Practice Address - Street 1:8878 US 70 HWY W STE 400A
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-4824
Practice Address - Country:US
Practice Address - Phone:919-550-5663
Practice Address - Fax:919-550-5761
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01575207RC0200X
NC200701575207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine