Provider Demographics
NPI:1245659077
Name:HAJIRAN, ALI JOHN (MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:JOHN
Last Name:HAJIRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 780
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-0780
Mailing Address - Country:US
Mailing Address - Phone:304-293-7401
Mailing Address - Fax:304-293-6983
Practice Address - Street 1:ONE STADIUM DRIVE, HSC, 9238
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-9238
Practice Address - Country:US
Practice Address - Phone:203-293-1254
Practice Address - Fax:304-293-4711
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV390200000208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology