Provider Demographics
NPI:1730131988
Name:DAVOUDI, ALI M
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:M
Last Name:DAVOUDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-3107
Mailing Address - Country:US
Mailing Address - Phone:419-228-0920
Mailing Address - Fax:419-228-0753
Practice Address - Street 1:1235 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-3107
Practice Address - Country:US
Practice Address - Phone:419-228-0920
Practice Address - Fax:419-228-0753
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111NN0400X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH403032406000OtherMEDICAL MUTUAL OF OH
OH000000134225OtherANTHEM
OH403032406000OtherMEDICAL MUTUAL OF OH