Provider Demographics
NPI:1497751853
Name:ALI, MOHAMMED ZULFEQUAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:ZULFEQUAR
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 1:147 GETTYS ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2534
Mailing Address - Country:US
Mailing Address - Phone:301-665-4740
Mailing Address - Fax:301-665-4741
Practice Address - Street 1:11110 MEDICAL CAMPUS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6700
Practice Address - Country:US
Practice Address - Phone:301-665-4740
Practice Address - Fax:301-665-4741
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426399207R00000X
MDD69527207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA247036OtherUNISON
PA25-1716306OtherINFORMED
PA25-1716306OtherHEALTHNET/TRICARE
PA3155293OtherMAMSI
PA800636OtherHEALTH AMERICA
PA1007307260034OtherMEDICAID GROUP #
PA1824751OtherAETNA HMO
PA50077015OtherCAPITAL BLUECROSS
PAMD426399OtherMEDICAL LICENSE #
PA1767580OtherHIGHMARK BLUE SHIELD
PAG920-0091/KDM4CUOtherCAREFIRST
PAP00683484OtherRAILROAD MEDICARE
PA101533006Medicaid
PA25-1716306OtherINTERGROUP
PA25-1716306OtherGREATWEST
PA25-1716306OtherFIRST HEALTH
PA1560150OtherGATEWAY
PA25-1716306OtherDEVON
PA867633OtherGROUP MEDICARE #
PA120420419OtherDEPT OF LABOR
PA25-1716306OtherSOUTH CENTRAL
PA25-1716306OtherMULTIPLAN/PHCS
PA7750649OtherAETNA NON-HMO
PA7750649OtherAETNA NON-HMO
PA25-1716306OtherGREATWEST
PABA8651704OtherDEA
PAMD426399OtherMEDICAL LICENSE #