Provider Demographics
NPI:1376681379
Name:ALI ORANDI M.D., PLC
Entity Type:Organization
Organization Name:ALI ORANDI M.D., PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:517-990-0029
Mailing Address - Street 1:1310 GREENWOOD AVE
Mailing Address - Street 2:SUITE 20
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3077
Mailing Address - Country:US
Mailing Address - Phone:517-990-0029
Mailing Address - Fax:517-990-0039
Practice Address - Street 1:1310 GREENWOOD AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3077
Practice Address - Country:US
Practice Address - Phone:517-990-0029
Practice Address - Fax:517-990-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301061289207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGMedicaid
MI0420088OtherPHP
MI1103811341OtherBCBS
MI4390534OtherCIGNA
MI1103811341OtherBCBS
MIPENDINGMedicaid