Provider Demographics
NPI:1093820300
Name:ALI, MANZOOR SHEIKH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MANZOOR
Middle Name:SHEIKH
Last Name:ALI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 WILDCAT CLIFFS LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-2969
Mailing Address - Country:US
Mailing Address - Phone:770-236-8388
Mailing Address - Fax:770-236-8388
Practice Address - Street 1:2118 WILDCAT CLIFFS LN
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-2969
Practice Address - Country:US
Practice Address - Phone:770-236-8388
Practice Address - Fax:770-236-8388
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050779207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine