Provider Demographics
NPI:1790825008
Name:ALI, MUHAMMAD (DO)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:27573 GATEWAY DR N
Mailing Address - Street 2:APT # 202
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4936
Mailing Address - Country:US
Mailing Address - Phone:248-225-8116
Mailing Address - Fax:248-352-1397
Practice Address - Street 1:1221 PINE GROVE AVE
Practice Address - Street 2:PORT HURON HOSPITAL EMERGENCY DEPT
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3511
Practice Address - Country:US
Practice Address - Phone:810-987-5000
Practice Address - Fax:810-385-4933
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101016042207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101016042OtherLICENSE