Provider Demographics
NPI:1346865722
Name:ALI, MUSAB ABDALHALIM (MD)
Entity Type:Individual
Prefix:
First Name:MUSAB
Middle Name:ABDALHALIM
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 1:1161 21ST AVENUE SOUTH
Mailing Address - Street 2:A-0118 MEDICAL CENTER SOUTH
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232
Mailing Address - Country:US
Mailing Address - Phone:615-322-0660
Mailing Address - Fax:
Practice Address - Street 1:1161 21ST AVENUE SOUTH
Practice Address - Street 2:A-0118 MEDICAL CENTER SOUTH
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232
Practice Address - Country:US
Practice Address - Phone:615-322-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2022-02-28
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2022-02-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program