Provider Demographics
NPI:1275783425
Name:ALI, HAMED (MD)
Entity Type:Individual
Prefix:DR
First Name:HAMED
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:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:521 MOYE BLVD FL 1
Practice Address - Street 2:ECU PHYSICIANS PULMONARY & CRITICAL CARE
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2849
Practice Address - Country:US
Practice Address - Phone:252-744-1600
Practice Address - Fax:252-744-1115
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 035781207RC0200X
DCMD 0357181207RP1001X
NC2012-01900207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC174HFOtherBCBSNC
NC5911118Medicaid
NCNC9509AMedicare PIN