Basic Information
Provider Information
NPI: 1902257504
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALI
FirstName: MUHAMMAD
MiddleName: Z
NamePrefix:  
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14680 NAIMISHA LOOP
Address2:  
City: SPRING HILL
State: FL
PostalCode: 346090777
CountryCode: US
TelephoneNumber: 3524427646
FaxNumber:  
Practice Location
Address1: 1102 W 32ND ST
Address2:  
City: JOPLIN
State: MO
PostalCode: 648043503
CountryCode: US
TelephoneNumber: 4173474570
FaxNumber: 4173476755
Other Information
ProviderEnumerationDate: 06/24/2016
LastUpdateDate: 06/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X23305FLN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X2021017377MOY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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