Provider Demographics
NPI:1528028230
Name:ALI, JAMAL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMAL
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9926 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-8905
Mailing Address - Country:US
Mailing Address - Phone:301-797-0066
Mailing Address - Fax:301-790-2886
Practice Address - Street 1:19236 MEADOW VIEW DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2908
Practice Address - Country:US
Practice Address - Phone:301-790-7999
Practice Address - Fax:301-790-2886
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00534052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD207RMedicare ID - Type UnspecifiedMEDICARE NUMBER
MDG79827Medicare UPIN