Basic Information
| Provider Information | |||||||||
| NPI: | 1104278829 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAZARI | ||||||||
| FirstName: | ALI RIZA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5621 COTTAGE HILL RD | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366094210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516662439 | ||||||||
| FaxNumber: | 2516663166 | ||||||||
| Practice Location | |||||||||
| Address1: | 5621 COTTAGE HILL RD | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366094210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516662439 | ||||||||
| FaxNumber: | 2516663166 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2016 | ||||||||
| LastUpdateDate: | 12/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/27/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD.38544 | AL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.