Provider Demographics
NPI:1558457432
Name:DOHAN, ALI M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:M
Last Name:DOHAN
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 1:1250 E COUNTY LINE ROAD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0989
Mailing Address - Country:US
Mailing Address - Phone:317-602-1400
Mailing Address - Fax:
Practice Address - Street 1:1250 E COUNTY LINE ROAD
Practice Address - Street 2:SUITE 8
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-0989
Practice Address - Country:US
Practice Address - Phone:317-602-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1041563A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100330790Medicaid
188120AMedicare PIN
INF76444Medicare UPIN