Provider Demographics
NPI:1669961033
Name:ALI, PETER RASHEED (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:RASHEED
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 MADISON AVE STE 314
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3454
Mailing Address - Country:US
Mailing Address - Phone:901-448-1683
Mailing Address - Fax:
Practice Address - Street 1:910 MADISON AVE STE 314
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3454
Practice Address - Country:US
Practice Address - Phone:901-448-1683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301114647390200000X
TN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program