Provider Demographics
NPI:1336104306
Name:ALI, ZULFIQAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ZULFIQAR
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 1:4623 W LISBON AVE
Mailing Address - Street 2:TENTATIVE
Mailing Address - City:MILWUAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208
Mailing Address - Country:US
Mailing Address - Phone:414-672-8050
Mailing Address - Fax:414-672-1050
Practice Address - Street 1:4555 W SCHROEDER DR
Practice Address - Street 2:SUITE 170
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-1496
Practice Address - Country:US
Practice Address - Phone:414-365-3210
Practice Address - Fax:414-365-3225
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47541207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1336104306Medicaid
I24468Medicare UPIN