Provider Demographics
NPI:1487837837
Name:ALI, SHABNAM (MD)
Entity Type:Individual
Prefix:
First Name:SHABNAM
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6350 STEVENS FOREST RD STE 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3240
Mailing Address - Country:US
Mailing Address - Phone:410-992-7400
Mailing Address - Fax:
Practice Address - Street 1:6350 STEVENS FOREST RD STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3240
Practice Address - Country:US
Practice Address - Phone:410-992-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0086506207RR0500X
NC201402149207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology