Provider Demographics
NPI:1134237803
Name:ALI, NASIMA (MD)
Entity type:Individual
Prefix:
First Name:NASIMA
Middle Name:
Last Name:ALI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 HERRINGTON RD BLDG 21805
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-7987
Mailing Address - Country:US
Mailing Address - Phone:770-822-4410
Mailing Address - Fax:
Practice Address - Street 1:1805 HERRINGTON RD BLDG 2
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-7987
Practice Address - Country:US
Practice Address - Phone:770-822-4410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA56797207R00000X
GA056797207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty