Provider Demographics
NPI:1881182665
Name:ALI, HAMMAD (MD)
Entity type:Individual
Prefix:MR
First Name:HAMMAD
Middle Name:
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 1:469 HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-9330
Mailing Address - Country:US
Mailing Address - Phone:307-387-9850
Mailing Address - Fax:307-387-9850
Practice Address - Street 1:469 HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-9330
Practice Address - Country:US
Practice Address - Phone:307-387-9850
Practice Address - Fax:307-387-9850
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2025-04-17
Deactivation Date:2018-11-29
Deactivation Code:
Reactivation Date:2018-12-31
Provider Licenses
StateLicense IDTaxonomies
WYTL8604207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY18244AOtherSTATE LICENSE