Provider Demographics
NPI:1285830265
Name:ALI, SHEIKH ASIM (MD)
Entity Type:Individual
Prefix:
First Name:SHEIKH
Middle Name:ASIM
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ASIM
Other - Middle Name:
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1600 RIVERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5671
Mailing Address - Country:US
Mailing Address - Phone:484-503-4600
Mailing Address - Fax:484-503-4679
Practice Address - Street 1:1600 RIVERSIDE CIR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5671
Practice Address - Country:US
Practice Address - Phone:484-503-4600
Practice Address - Fax:484-503-4679
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017457207RH0003X
PAMD433379207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102085322Medicaid
PA102085322Medicaid