Provider Demographics
NPI:1720167687
Name:SULEIMAN, ALI AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:AHMAD
Last Name:SULEIMAN
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 1:200 E BUNTING LN
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3678
Mailing Address - Country:US
Mailing Address - Phone:304-255-7878
Mailing Address - Fax:304-256-0060
Practice Address - Street 1:242 GEORGE ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2641
Practice Address - Country:US
Practice Address - Phone:304-255-7878
Practice Address - Fax:304-256-0060
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16913174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0087747000Medicaid
WVF38286Medicare UPIN
WV0087747000Medicaid