Provider Demographics
NPI:1790849370
Name:ALI, MOHAMMAD K
Entity Type:Individual
Prefix:MR
First Name:MOHAMMAD
Middle Name:K
Last Name:ALI
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 1:5310 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2263
Mailing Address - Country:US
Mailing Address - Phone:414-442-3000
Mailing Address - Fax:414-442-3050
Practice Address - Street 1:5310 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2263
Practice Address - Country:US
Practice Address - Phone:414-442-3000
Practice Address - Fax:414-442-3050
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic