Provider Demographics
NPI:1790709913
Name:ALI, MUHAMMAD WASIM-SADIQ (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:WASIM-SADIQ
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 1:1090 HIGHWAY 78 E
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-3959
Mailing Address - Country:US
Mailing Address - Phone:205-387-9787
Mailing Address - Fax:205-387-9952
Practice Address - Street 1:1090 HIGHWAY 78 E
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3959
Practice Address - Country:US
Practice Address - Phone:205-387-9787
Practice Address - Fax:205-387-9952
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL222192084N0400X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Not Answered2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51046036OtherBC/BS
AL51046036OtherBC/BS