Provider Demographics
NPI:1265429211
Name:ALI, SAMI T (MD)
Entity type:Individual
Prefix:
First Name:SAMI
Middle Name:T
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 E TUDOR RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1282
Mailing Address - Country:US
Mailing Address - Phone:907-565-8005
Mailing Address - Fax:907-565-8066
Practice Address - Street 1:3200 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4661
Practice Address - Country:US
Practice Address - Phone:907-261-3111
Practice Address - Fax:907-565-8066
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5193207P00000X
TXL2090207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD30541Medicaid
TX81417Medicaid
AKMD30541Medicaid
TX8D0249Medicare PIN
TX8D0248Medicare PIN
TX8D2033Medicare PIN
AKK160188Medicare ID - Type Unspecified
TX8678K5Medicare PIN
H01261Medicare UPIN
TX8D0247Medicare PIN