Provider Demographics
NPI:1164690731
Name:PULMONOLOGY & BRONCHOLOGY
Entity Type:Organization
Organization Name:PULMONOLOGY & BRONCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIR
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-212-9101
Mailing Address - Street 1:8878 US 70 HWY W
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-4823
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
Practice Address - Street 2:SUITE 400A
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-4823
Practice Address - Country:US
Practice Address - Phone:919-550-5663
Practice Address - Fax:919-550-5761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty