Provider Demographics
NPI:1497880223
Name:ALI, SHAHID (MD)
Entity Type:Individual
Prefix:
First Name:SHAHID
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:PO BOX 22329
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37202-2329
Mailing Address - Country:US
Mailing Address - Phone:615-327-2692
Mailing Address - Fax:615-327-1009
Practice Address - Street 1:2401 PARMAN PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1518
Practice Address - Country:US
Practice Address - Phone:615-327-2692
Practice Address - Fax:615-327-1009
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN312652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
3399335Medicare ID - Type Unspecified
G67984Medicare UPIN
3399335Medicare ID - Type Unspecified