Provider Demographics
NPI:1629275789
Name:AL-ALI, MOHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:AL-ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8220 S SAGINAW ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1890
Mailing Address - Country:US
Mailing Address - Phone:810-695-5864
Mailing Address - Fax:810-771-4318
Practice Address - Street 1:8220 S SAGINAW ST STE 800
Practice Address - Street 2:GENESEE LUNG ASSOCIATES PC
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1890
Practice Address - Country:US
Practice Address - Phone:810-695-5864
Practice Address - Fax:810-695-2412
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2023-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301106318207RC0200X, 2084A2900X, 207RP1001X
MI5315068713207RP1001X
ME18469207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1629275789Medicaid
MI1629275789Medicaid
MI001663301Medicare PIN