Provider Demographics
NPI:1093131559
Name:SAMEERAH ALI MOBILE MED PLLC
Entity Type:Organization
Organization Name:SAMEERAH ALI MOBILE MED PLLC
Other - Org Name:SAMEERAH ALI
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMEERAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:480-457-0422
Mailing Address - Street 1:2072 NASHBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3869
Mailing Address - Country:US
Mailing Address - Phone:480-457-0422
Mailing Address - Fax:
Practice Address - Street 1:1602 8TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5009
Practice Address - Country:US
Practice Address - Phone:615-379-8474
Practice Address - Fax:615-730-7132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care