Provider Demographics
NPI:1821640525
Name:ALI, MAHAM (MD)
Entity type:Individual
Prefix:
First Name:MAHAM
Middle Name:
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:G3230 BEECHER RD STE 2
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3604
Mailing Address - Country:US
Mailing Address - Phone:810-342-5800
Mailing Address - Fax:810-342-5810
Practice Address - Street 1:1019 N LAFAYETTE ST STE 1
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3746
Practice Address - Country:US
Practice Address - Phone:704-487-9766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351044936207R00000X
NC2024-01270207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine