Provider Demographics
NPI:1841467735
Name:HAMA AMIN, ALI M (MD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:M
Last Name:HAMA AMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2001 CRYSTAL SPRING AVE SW STE 203
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-2465
Mailing Address - Country:US
Mailing Address - Phone:540-982-8204
Mailing Address - Fax:540-224-1059
Practice Address - Street 1:2001 CRYSTAL SPRING AVE SW STE 203
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-982-8204
Practice Address - Fax:540-224-1059
Is Sole Proprietor?:No
Enumeration Date:2008-05-11
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233326207R00000X
VA0101246989207R00000X
WV390200000X
VI0101246989207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program