Provider Demographics
NPI:1013131275
Name:RAJA, ALI I (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:I
Last Name:RAJA
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5918 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3326
Mailing Address - Country:US
Mailing Address - Phone:501-227-1860
Mailing Address - Fax:
Practice Address - Street 1:5918 LEE AVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3326
Practice Address - Country:US
Practice Address - Phone:501-227-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4731207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00622542OtherRAILROAD MEDICARE
AR172805001Medicaid
ARP00622530OtherRAILROAD MEDICARE
AR5H271Medicare PIN
PA118488FKCMedicare PIN