Provider Demographics
NPI:1346867439
Name:ALI, KINZA (MD)
Entity Type:Individual
Prefix:
First Name:KINZA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2055 KIMBALL AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702
Mailing Address - Country:US
Mailing Address - Phone:647-505-0120
Mailing Address - Fax:319-272-2107
Practice Address - Street 1:2055 KIMBALL AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702
Practice Address - Country:US
Practice Address - Phone:647-505-0120
Practice Address - Fax:319-272-2107
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAR-11752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine