Provider Demographics
NPI:1295588242
Name:ANANI, AHMAD ALI (ND)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:ALI
Last Name:ANANI
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 DANVERS LN
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1018
Mailing Address - Country:US
Mailing Address - Phone:313-415-4901
Mailing Address - Fax:
Practice Address - Street 1:22022 MICHIGAN AVE STE 27
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2889
Practice Address - Country:US
Practice Address - Phone:313-437-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1143175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath