Provider Demographics
NPI:1487643292
Name:ALI, NAYAB (MD)
Entity Type:Individual
Prefix:
First Name:NAYAB
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 1:10960 MARTINGALE CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1560
Mailing Address - Country:US
Mailing Address - Phone:301-299-9248
Mailing Address - Fax:202-675-0411
Practice Address - Street 1:315 8TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-6107
Practice Address - Country:US
Practice Address - Phone:202-543-8068
Practice Address - Fax:202-675-0411
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC5051207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC011071200Medicaid
DC011071200Medicaid
AL408912Medicare ID - Type Unspecified